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HumanaChoice Florida H7284-001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Florida H7284-001 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Florida H7284-001 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice Florida H7284-001 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Lake, Marion, Seminole and Sumter counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Florida H7284-001 (PPO) 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 HumanaChoice Florida H7284-001 (PPO).
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 HumanaChoice Florida H7284-001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $79.00. 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 $615.00 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 combined Maximum Out-Of-Pocket cost of $5100.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $5100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 HumanaChoice Florida H7284-001 (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for 1-month and 3-month supplies at standard pharmacies or through preferred mail order. Tier 2 generic medications are also highly affordable, requiring a $10 copay for a 1-month supply at standard pharmacies and no copay for a 3-month supply filled via preferred mail order. For brand-name and specialized medications, Tier 3 preferred brand drugs have a $47 copay for a 1-month supply across standard pharmacies and mail order options. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs carry a 25% coinsurance for a 1-month supply. This prescription drug coverage offers a clear mix of copayments and coinsurance to help you manage your healthcare expenses.
Additional Benefits
The HumanaChoice Florida H7284-001 (PPO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a $125 daily copay for days 1 to 10 and no copay for days 11 to 90, with no coinsurance required. Specialist visits and Medicare-covered dental services are also highly affordable, requiring only a $20 copay and no coinsurance. Routine vision and hearing exams are covered with no copay, alongside allowances of up to $200 for eyewear and $1,000 for prescription hearing aids. Dental benefits include preventive care with no copay and restorative services with a $25 copay up to a $1,000 annual limit. Additionally, diagnostic lab tests and outpatient X-rays require no copay, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HumanaChoice Florida H7284-001 (PPO) covers inpatient hospital services with no coinsurance, requiring a $125 daily copay for days 1 to 10 and no copay for days 11 to 90 for both acute and psychiatric stays. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by HumanaChoice Florida H7284-001 (PPO) with no coinsurance, featuring a $0 to $125 copay for outpatient hospital services and a $125 copay per stay for observation services. Ambulatory surgical center and blood services require no copay, while outpatient substance abuse sessions have a copay ranging from $20 to $35.
Partial Hospitalization See details
HumanaChoice Florida H7284-001 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HumanaChoice Florida H7284-001 (PPO) covers ambulance services with a $120 to $240 copay for ground transport and a 20% coinsurance for air transport, both requiring prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
HumanaChoice Florida H7284-001 (PPO) covers emergency services with a $150 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $15 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $150 copay and no coinsurance.
Primary Care See details
HumanaChoice Florida H7284-001 (PPO) primary care benefits feature primary care physician visits with no copay and no coinsurance, while specialist and mental health services require a $20 copay and no coinsurance. Physical, occupational, and speech therapy services are available with a $5 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
HumanaChoice Florida H7284-001 (PPO) covers preventive services, including annual physical exams, kidney disease education, and select fitness and in-home support benefits, with no copay and no coinsurance. This benefit is partially covered, as supplemental services such as health education, nutritional therapy, personal emergency response systems (PERS), and home safety modifications are not covered.
Hearing Services See details
HumanaChoice Florida H7284-001 (PPO) covers hearing services with no coinsurance, offering Medicare-covered exams for a $20 copay and annual routine exams, fittings, and OTC hearing aids for no copay. Prescription hearing aids are partially covered with no copay up to a $1,000 limit every three years, excluding inner ear, outer ear, and over-the-ear models.
Vision Services See details
HumanaChoice Florida H7284-001 (PPO) covers routine eye exams and eyewear with no copay, no coinsurance, and no deductible, featuring an annual maximum benefit of $75 for exams and $200 for contacts or eyeglasses. This benefit is partially covered, as other eye exam services, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice Florida H7284-001 (PPO), which offers preventive care with no copay and no coinsurance, Medicare-covered dental for a $20 copay and no coinsurance, and restorative and periodontic services for a $25 copay and no coinsurance under a $1,000 annual limit. Fluoride treatment, endodontics, fixed and removable prosthodontics, implants, maxillofacial prosthetics, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice Florida H7284-001 (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while covered Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HumanaChoice Florida H7284-001 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice Florida H7284-001 (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with a 20% coinsurance and no copay. Diabetic therapeutic shoes and inserts are covered with a $5 copay and no coinsurance, and prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice Florida H7284-001 (PPO) with no coinsurance, though prior authorization is required. There is no copay for lab services and outpatient X-rays, while diagnostic procedures and tests carry a copay of $0 to $125, and therapeutic radiological services have a minimum copay of $20.
Home Health Services See details
HumanaChoice Florida H7284-001 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the HumanaChoice Florida H7284-001 (PPO) plan, but in practice some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered. These non-covered services carry copayments ranging from $5 to $30 and require prior authorization.
Skilled Nursing Facility (SNF) See details
HumanaChoice Florida H7284-001 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $160 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HumanaChoice Florida H7284-001 (PPO) partially covers other services, offering acupuncture with no copay and no coinsurance for up to 25 treatments per year with prior authorization. However, over-the-counter (OTC) items and meal benefits are not covered under this plan.
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