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Humana FMOL Baton Rouge H1951-053 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana FMOL Baton Rouge H1951-053 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana FMOL Baton Rouge H1951-053 (HMO) in 2026, please refer to our full plan details page.
Humana FMOL Baton Rouge H1951-053 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Baton Rouge Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana FMOL Baton Rouge H1951-053 (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana FMOL Baton Rouge H1951-053 (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Humana FMOL Baton Rouge H1951-053 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $41.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Humana FMOL Baton Rouge H1951-053 (HMO) plan features an annual drug deductible of $590. You can save on prescriptions with no copay for Tier 1 preferred generic drugs at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, requiring a $5 copay for a one-month supply and no copay for a three-month supply when using preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply at standard pharmacies or through mail order. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 47% coinsurance and Tier 5 specialty drugs requiring a 26% coinsurance. These cost-sharing tiers help you understand your out-of-pocket drug costs under this Humana Medicare plan.
Additional Benefits
The Humana FMOL Baton Rouge H1951-053 (HMO) plan offers affordable healthcare coverage with no copay for primary care visits and routine preventive screenings. Inpatient hospital stays require a $75 daily copay for the first 10 days, while emergency room visits carry a $150 copay that is waived if you are admitted. Outpatient care features no coinsurance, with copays ranging from no copay for ambulatory surgical center services up to a $100 copay for outpatient hospital services. For specialized care, members pay a $20 copay for specialists, physical therapy, and Medicare-covered dental, vision, or hearing exams. The plan also includes valuable extra benefits, such as up to $2,000 in preventive and comprehensive dental coverage and routine hearing exams with no copay. Additionally, you can access home health services and up to 60 one-way trips to plan-approved locations each year with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana FMOL Baton Rouge H1951-053 (HMO) with no coinsurance, requiring a $75 daily copay for days 1 through 10 and no copay for days 11 through 90. This benefit is partially covered because non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $100, observation services carry a $75 copay per stay, and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and emergency transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Primary care benefits under the Humana FMOL Baton Rouge H1951-053 (HMO) feature primary care physician services with no copay and no coinsurance, while specialist, occupational therapy, and physical therapy visits require a $20 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services are covered with a $35 copay and no coinsurance, whereas telehealth copays range from $0 to $65 with no coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers preventive services with no copays and no coinsurance, including annual physical exams, kidney disease education, and select screenings. However, additional preventive benefits are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, caregiver support, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are covered by Humana FMOL Baton Rouge H1951-053 (HMO) with no deductible, including Medicare-covered exams for a $20 copay and no coinsurance, and annual routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are partially covered with a $399 to $699 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types, while over-the-counter hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Vision Services are partially covered by Humana FMOL Baton Rouge H1951-053 (HMO), offering covered exams and eyewear with no coinsurance and copays ranging from $0 to $20. While routine eye exams, contact lenses, and eyeglasses are covered, other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) partially covers dental services, offering Medicare-covered dental with a $20 copay and no coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $2,000 annual limit. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Humana FMOL Baton Rouge H1951-053 (HMO) with no copay, but prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Humana FMOL Baton Rouge H1951-053 (HMO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Humana FMOL Baton Rouge H1951-053 (HMO), with durable medical equipment, prosthetics, and medical supplies requiring a 20% coinsurance and no copay. Diabetic supplies feature a 10% to 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts require a $10 copay and a 10% to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana FMOL Baton Rouge H1951-053 (HMO) with prior authorization required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $65 copay for procedures, while radiological services range from no copay for outpatient X-rays to a minimum 20% coinsurance and $20 copay for therapeutic services.
Home Health Services See details
Home health services are covered under the Humana FMOL Baton Rouge H1951-053 (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Humana FMOL Baton Rouge H1951-053 (HMO) with no coinsurance and require prior authorization. While some services are covered, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a $20 copay.
Skilled Nursing Facility (SNF) See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 to 20 and a $218 copayment per day for days 21 to 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
Humana FMOL Baton Rouge H1951-053 (HMO) covers acupuncture with a $20 copay and no coinsurance for up to 20 treatments per year with prior authorization. The plan also covers over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for the meal benefit.
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