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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 2025, 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 Cleveland Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2025.
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. Additionally, this plan comes with a Part B Premium reduction of $3.00. 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 $250.00 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 $5900.00 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 $250 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance for your medications depending on the drug tier and pharmacy. For example, for preferred generic drugs, you'll pay a $5 copay at preferred and mail-order pharmacies, and a $20 copay at standard pharmacies. For preferred brand drugs, you'll pay 50% coinsurance, regardless of the pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Cleveland Clinic Preferred (HMO-POS) plan offers a range of benefits with varying costs. This plan covers inpatient hospital stays with a copay, and outpatient services with copays for certain services, while some services have no copay. Emergency, primary care, and preventive services are also covered, with copays or no copays depending on the service. Additional benefits include coverage for hearing, vision, and dental services, with copays and coinsurance applying to specific services. The plan also provides coverage for home infusion, dialysis, medical equipment, diagnostic services, and home health services. Some services, like ambulance, mental health, and skilled nursing facility, have copays associated with them.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $445 for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute, and a copay of $445 for days 1-5, and no copay for days 6-90 for Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and 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 $445, observation services with a $445 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $25 and $100 for individual and group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Cleveland Clinic Preferred (HMO-POS) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, each with a $315 copay. Transportation Services to a plan-approved health-related location are also covered with no copay, up to 24 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Humana Cleveland Clinic Preferred (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services have a $55 copay, and there is no coinsurance for any of these services.
Primary Care See details
The Humana Cleveland Clinic Preferred (HMO-POS) plan offers coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $15-$45 copay, Physician Specialist Services with a $25 copay, and Mental Health Specialty Services with a $25 copay. This plan also covers Physical Therapy and Speech-Language Pathology Services with a $15-$45 copay, Additional Telehealth Benefits with a $0-$55 copay, and Opioid Treatment Program Services with a $25-$100 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The Humana Cleveland Clinic Preferred (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, and fitness benefits have a copay of $0. Kidney disease education services, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit have no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams have no copay. Fitting/evaluation for hearing aids has no copay, and prescription hearing aids (all types) have a copay between $699 and $999. OTC hearing aids are covered up to $100 every three months.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$25, and eyewear with a copay of $0. Contact lenses and eyeglasses (lenses and frames) are covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a $4,000 annual maximum benefit. Medicare dental services have a $25 copay, while oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services have no copay. Prosthodontics, fixed and removable, have a 30% coinsurance, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The cost for Medicare Part B Insulin Drugs includes a $35 copay and coinsurance between 0% and 20%, while the cost for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs includes coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Cleveland Clinic Preferred (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical equipment benefits are covered, including durable medical equipment with 20% coinsurance and authorization required, prosthetics and medical supplies with 20% coinsurance, and diabetic equipment. Diabetic supplies have a coinsurance between 10% and 20%, and diabetic therapeutic shoes/inserts have a copay of $10.00.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for Medicare-covered diagnostic procedures, tests, and lab services. Diagnostic Procedures/Tests have a copay between $0 and $105, and Lab Services have no copay. Radiological Services have a copay for Medicare-covered diagnostic and therapeutic radiological services, and X-rays have no copay. Therapeutic Radiological Services have a 20% coinsurance and a copay up to $25.
Home Health Services See details
Home Health Services are covered by the Humana Cleveland Clinic Preferred (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Humana Cleveland Clinic Preferred (HMO-POS) plan. For days 1-20, there is a $10 copay, and for days 21-100, there is a $214 copay; additional days beyond Medicare-covered SNF and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Cleveland Clinic Preferred (HMO-POS) plan covers acupuncture with a $25 copay, OTC items with a $100 maximum benefit every three months, and a meal benefit with no copay. The plan does not cover Dual Eligible SNPs with Highly Integrated Services or the following additional 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.
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