A non-government entity
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 2025, 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 2025.
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 $39.00. 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:
Sign up for Humana FMOL Baton Rouge H1951-053 (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana FMOL Baton Rouge H1951-053 (HMO) plan has a $590.00 deductible for prescription drugs. After meeting the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, in the initial coverage phase, you may pay a $10.00 copay for preferred generic drugs at a standard pharmacy, or 45% coinsurance for preferred brand drugs. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Humana FMOL Baton Rouge H1951-053 (HMO) plan offers a range of benefits with varying costs. It includes inpatient hospital care with a copay, outpatient services with copays, and coverage for emergency services. This plan also covers primary care, preventive services, hearing, vision, and dental services, often with copays. Additionally, it provides benefits for ambulance, home infusion, and medical equipment, with some services requiring coinsurance or prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, there is a $75 copay for days 1-10, and no copay for days 11-90, and no coinsurance. Additional days for acute care have no copay. Psychiatric care has a $75 copay for days 1-10, and no copay for days 11-90, and no coinsurance. Non-Medicare-covered stays and upgrades for inpatient hospital acute, as well as additional days and non-Medicare-covered stays for inpatient hospital psychiatric, are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $100, observation services with a $75 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $20 copay for individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $20 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana FMOL Baton Rouge H1951-053 (HMO) plan. Ground Ambulance Services have a $315 copay, while Air Ambulance Services have a 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Humana FMOL Baton Rouge H1951-053 (HMO) plan. Emergency Services has a $140 copay with no coinsurance, Urgently Needed Services has a $65 copay with no coinsurance, and Worldwide Emergency Services has a $140 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $20 copay, Physician Specialist Services with a $20 copay, Mental Health Specialty Services with a $20 copay, Other Health Care Professional with a copay between $0 and $20, Psychiatric Services with a $20 copay, Physical Therapy and Speech-Language Pathology Services with a $20 copay, Additional Telehealth Benefits with a copay between $0 and $65, and Opioid Treatment Program Services with a $20 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The Humana FMOL Baton Rouge H1951-053 (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including smoking cessation counseling and fitness benefits, are covered with no copay. Other services like health education and home-based palliative care are not covered.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $20 copay. Routine hearing exams are covered with no copay for one exam per year. Fitting/evaluation for hearing aids is covered with no copay. Prescription hearing aids are partially covered, with a copay between $399 and $699 for all types, but not for inner, outer, or over-the-ear hearing aids. OTC hearing aids are covered with a maximum benefit of $25 every three months.
Vision Services See details
The Humana FMOL Baton Rouge H1951-053 (HMO) plan covers vision services, including eye exams with a copay between $0 and $20. The plan also covers eyewear, including contact lenses and eyeglasses, with a combined maximum benefit of $300 per year and no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $20 copay, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery with no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
The Humana FMOL Baton Rouge H1951-053 (HMO) plan covers home infusion bundled services, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and other Medicare Part B Drugs with 0-20% coinsurance. The plan requires prior authorization for these services.
Dialysis Services See details
Dialysis Services are covered by the Humana FMOL Baton Rouge H1951-053 (HMO) plan, with a coinsurance of 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Equipment is covered with coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts and copays for Medicare-covered Diabetes Supplies and Diabetic Therapeutic Shoes or Inserts, with Diabetic Supplies having a 10-20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts having a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for some services between $0 and $65, and lab services with no copay. Diagnostic Radiological Services have a copay up to $325, while Therapeutic Radiological Services have a copay of at least $20, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana FMOL Baton Rouge H1951-053 (HMO) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the Humana FMOL Baton Rouge H1951-053 (HMO) plan, but require prior authorization. The copay is $20 for days 1-20, and $214 for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes acupuncture with a $20 copay, and a limit of 20 treatments per year. Over-the-counter items are covered, with a maximum benefit coverage amount of $25 every three months. The plan also offers a meal benefit with no copay, and the benefit is for a chronic illness. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved