Humana USAA Honor Giveback (PPO)

Inpatient Hospital See details

The Humana USAA Honor Giveback (PPO) plan covers inpatient hospital stays, including acute and psychiatric care. For acute care, you'll pay a copay of $590 for days 1-4 and no copay for days 5-90, with additional days (91-999) covered with no copay. Psychiatric care has a copay of $509 for days 1-4 and no copay for days 5-90; additional days and non-Medicare-covered stays are not covered.

Outpatient Services See details

Outpatient Services include coverage for all outpatient hospital services with a 20% coinsurance and a copay between $0 and $495, observation services with a $590 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services, including individual and group sessions, have a 20% coinsurance and a copay between $35.00 and $35.00. Outpatient blood services are covered with no copay.

Partial Hospitalization See details

Partial Hospitalization is covered under the Humana USAA Honor Giveback (PPO) plan and requires prior authorization. You will pay a copay of $80 for this benefit.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered by the Humana USAA Honor Giveback (PPO) plan. Ground Ambulance Services have a $315 copay, while Air Ambulance Services have a $1250 copay; there is no coinsurance for either. 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 by the Humana USAA Honor Giveback (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay; all have no coinsurance.

Primary Care See details

The Humana USAA Honor Giveback (PPO) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $25 copay, Physician Specialist Services with a $50 copay, and Physical Therapy and Speech-Language Pathology Services with a $25 copay; however, Routine Chiropractic Care is not covered, and Podiatry Services are not covered. The plan also covers Mental Health Specialty Services and Psychiatric Services with no copay for individual and group sessions. Additionally, Additional Telehealth Benefits are covered with a copay ranging from $0 to $50, and Opioid Treatment Program Services are covered with a 20% coinsurance and a $35 copay.

Preventive Services See details

The Humana USAA Honor Giveback (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services such as health education, in-home safety assessments, and more are not covered. Other services like glaucoma screening, diabetes self-management training, and others have no copay.

Hearing Services See details

Hearing Services include coverage for Hearing Exams with a $50 copay, Routine Hearing Exams with no copay, and Fitting/Evaluation for Hearing Aids with no copay. Prescription Hearing Aids are partially covered, with coverage for Prescription Hearing Aids (all types) with a copay between $699 and $999, but Inner Ear, Outer Ear, and Over the Ear hearing aids are not covered, and OTC Hearing Aids are not covered.

Vision Services See details

Vision services include eye exams with a copay between $0 and $50, and eyewear with no copay, while eyeglass lenses, eyeglass frames, and upgrades are not covered. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered with no copay.

Dental Services See details

The Humana USAA Honor Giveback (PPO) plan covers dental services, including 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, all with no copay. However, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered, and Medicare Dental Services require a $50 copay. The plan has a maximum benefit of $1,500 per year, and prior authorization is required for some services.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered under the Humana USAA Honor Giveback (PPO) plan and require prior authorization. The plan has a $35 copay for Medicare Part B Insulin Drugs, and the coinsurance for all other Medicare Part B drugs ranges from 0% to 20%.

Dialysis Services See details

Dialysis Services are covered under the Humana USAA Honor Giveback (PPO) plan. The plan requires prior authorization and has a coinsurance of 20%.

Medical Equipment See details

The Humana USAA Honor Giveback (PPO) plan covers medical equipment, including durable medical equipment with an 18% coinsurance, prosthetic devices with an 18% coinsurance, and medical supplies with an 18% coinsurance. Diabetic supplies have a 10-20% coinsurance and no copay, and diabetic therapeutic shoes/inserts have no copay.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $50, and lab services with no copay. Radiological services are covered, including diagnostic radiological services with a copay up to $495, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with no copay.

Home Health Services See details

Home Health Services are covered by the Humana USAA Honor Giveback (PPO) 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 not covered by the Humana USAA Honor Giveback (PPO) plan. Prior authorization is required for these services, but the plan does not cover them.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered by the Humana USAA Honor Giveback (PPO) plan. For days 1-20, there is no copay, days 21-85 have a $214 copay, and days 86-100 have no copay.

Other Services See details

Other Services include acupuncture and a meal benefit. Acupuncture has a $50 copay and is limited to 20 treatments per year, while the meal benefit has no copay.

Over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.