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Humana Cleveland Clinic Preferred (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Cleveland Clinic Preferred (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Cleveland Clinic Preferred (HMO-POS) in 2026, please refer to our full plan details page.
Humana Cleveland Clinic Preferred (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Cuyahoga County. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Cleveland Clinic Preferred (HMO-POS) 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 Cleveland Clinic Preferred (HMO-POS).
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 Cleveland Clinic Preferred (HMO-POS), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $500.00 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 $7000.00 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 Cleveland Clinic Preferred (HMO-POS) plan has a $500 annual drug deductible. You will pay no copay for Tier 1 preferred generic drugs when using a standard pharmacy or preferred mail order. Tier 2 generic drugs cost a $5 copay for a 1-month supply, or no copay for a 3-month supply through preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a 1-month supply at standard pharmacies or via mail order. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs carry a 27% coinsurance for a 1-month supply. This clear breakdown of copays and coinsurance helps you estimate your out-of-pocket prescription costs.
Additional Benefits
The Humana Cleveland Clinic Preferred (HMO-POS) plan offers robust medical coverage, featuring no copay for primary care physician visits, preventive care, and home health services. Specialist visits require a $45 copay, while inpatient hospital stays have a $485 copay for the first five days of acute stays with no copay for the remaining covered days. Emergency room visits carry a $115 copay, which is waived if you are admitted, while urgent care services require a $40 copay. For supplemental health benefits, members enjoy no copay for routine dental care up to a $4,000 annual limit, routine vision exams, and routine hearing services. Skilled nursing facility stays feature no copay for the first 20 days, and the plan covers up to 24 one-way transportation trips per year with no copay. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Cleveland Clinic Preferred (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $485 copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, followed by no copay for the remaining covered days. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Cleveland Clinic Preferred (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $550 copay for outpatient hospital services, a $485 copay per stay for observation services, and a $35 copay for outpatient substance abuse sessions. Additionally, there is no copay and no coinsurance for ambulatory surgical center services and outpatient blood services, though prior authorization is required.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Cleveland Clinic Preferred (HMO-POS) with a $35 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Cleveland Clinic Preferred (HMO-POS) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Humana Cleveland Clinic Preferred (HMO-POS) with a $115 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Cleveland Clinic Preferred (HMO-POS) primary care benefits feature no copay and no coinsurance for primary care physician visits, while specialist visits require a $45 copay and no coinsurance. Other covered services, including physical therapy, occupational therapy, mental health, and telehealth, have copays ranging from $0 to $45 with no coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
Humana Cleveland Clinic Preferred (HMO-POS) partially covers preventive services with no copay and no coinsurance for annual exams, kidney disease education, and screenings. Covered supplemental benefits include memory fitness, smoking cessation, and chemotherapy wigs, while health education, personal emergency response systems, in-home safety assessments, nutritional therapy, and weight management programs are not covered.
Hearing Services See details
Humana Cleveland Clinic Preferred (HMO-POS) hearing services are partially covered, offering Medicare-covered exams for a $45 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids have no copay and no coinsurance. Prescription hearing aids are covered with copays ranging from $699 to $999 and no coinsurance for up to two aids per year, though inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Humana Cleveland Clinic Preferred (HMO-POS) partially covers vision services, offering routine eye exams and select eyewear with no copays, no coinsurance, and no deductibles, up to a $100 annual limit. Prior authorization is required, and other eye exams, standalone eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Cleveland Clinic Preferred (HMO-POS) partially covers dental services up to a $4,000 annual limit, offering no copay and no coinsurance for most preventive and comprehensive care, while prosthodontics require a 30% coinsurance (no copay) and Medicare-covered dental has a $45 copay (no coinsurance). Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Cleveland Clinic Preferred (HMO-POS) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs carry a $35 copay and up to 20% coinsurance.
Dialysis Services See details
The Humana Cleveland Clinic Preferred (HMO-POS) plan covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Humana Cleveland Clinic Preferred (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Cleveland Clinic Preferred (HMO-POS) with prior authorization, featuring no copay for lab services and outpatient X-rays. Outpatient diagnostic tests range from no copay to a $105 copay with no coinsurance, diagnostic radiology starts at no copay, and therapeutic radiology requires a minimum 20% coinsurance and a minimum $25 copay.
Home Health Services See details
Home health services are covered by Humana Cleveland Clinic Preferred (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Humana Cleveland Clinic Preferred (HMO-POS) plan. This includes intensive cardiac, pulmonary, and SET for PAD rehabilitation services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Humana Cleveland Clinic Preferred (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Humana Cleveland Clinic Preferred (HMO-POS) covers other services, including acupuncture with a $45 copay and no coinsurance, alongside over-the-counter items and chronic illness meals with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and some services within this benefit category are not covered, including certain drugs on the CMS over-the-counter list.
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