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HumanaChoice Florida H7284-008 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Florida H7284-008 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Florida H7284-008 (PPO) in 2025, please refer to our full plan details page.
HumanaChoice Florida H7284-008 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Broward, Miami-Dade, and Palm Beach counties. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that HumanaChoice Florida H7284-008 (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 H7284-008 (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 H7284-008 (PPO), 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 $1.30. 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 $150.00 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 $6200.00 (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 $6200.00 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 H7284-008 (PPO) plan has a $150 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you will pay a $5 copay for preferred generic drugs at a standard pharmacy or a preferred mail pharmacy. For standard generic drugs, you will pay a $47 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The HumanaChoice Florida H7284-008 (PPO) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay, outpatient services with varying copays and coinsurance, and emergency services with a copay. Preventive services, such as an annual physical exam, are covered with no copay. This plan also provides coverage for primary care physician services with no copay, and offers benefits for hearing, vision, and dental services, with associated copays. Additional benefits include home health services with no copay, ambulance services with a copay or coinsurance, and medical equipment with coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric services. For Inpatient Hospital-Acute, you'll pay a $415 copay for days 1-7 and no copay for days 8-90, while additional days have no copay; for Inpatient Hospital Psychiatric, you'll pay a $415 copay for days 1-5 and no copay for days 6-90. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $0 - $315 copay and 20% coinsurance, Observation Services with a $415 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a $30 copay and 20% coinsurance, and Outpatient Blood Services with no copay. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $35 copay. Prior authorization is required.
Ambulance and Transportation Services See details
For HumanaChoice Florida H7284-008 (PPO), ambulance services are covered, with a coinsurance for Medicare-covered ground ambulance services and a copay for Medicare-covered air ambulance services, while transportation services to health-related locations are not covered. Ground ambulance services have a copay of $120.00 - $240.00, and air ambulance services have a 20% coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, Urgently Needed Services have a $15 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $140 copay.
Primary Care See details
The HumanaChoice Florida H7284-008 (PPO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a copay between $10 and $35, while physician specialist services have a $35 copay. Mental health and psychiatric individual and group sessions have a $30 copay. Physical therapy and speech-language pathology services have a copay between $10 and $35. Additional telehealth benefits have a copay between $0 and $35. Opioid treatment program services have a 20% coinsurance and a copay between $30.
Preventive Services See details
The HumanaChoice Florida H7284-008 (PPO) plan covers preventive services, including an annual physical exam with no copay, and also covers kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, 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, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services.
Hearing Services See details
Hearing Services includes hearing exams and prescription hearing aids, though the plan does not cover routine hearing exams, fitting/evaluation for hearing aids, or any prescription hearing aids. Hearing exams have a $35 copay.
Vision Services See details
Vision services include eye exams with a copay of $0-$35 and a maximum benefit of $75 every year. Eyewear is covered with no copay, and a combined maximum benefit of $150 every year for contact lenses and eyeglasses (lenses and frames); however, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The HumanaChoice Florida H7284-008 (PPO) plan covers Medicare dental services with a $35 copay, oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay. Fluoride treatment, restorative services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the HumanaChoice Florida H7284-008 (PPO) plan. For Medicare Part B insulin drugs, there is a $35 copay, and a coinsurance between 0% and 20%. Other Medicare Part B drugs, as well as Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment are covered. DME has a 13% coinsurance, and a copay of $0. Prosthetic devices and medical supplies have a 20% coinsurance, while diabetic supplies have a 20% coinsurance with no copay, and diabetic therapeutic shoes/inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests, lab services, and radiological services. Diagnostic Procedures/Tests have a coinsurance of at most 20% with a copay of up to $200, while Lab Services have no copay and a coinsurance of at most 20%. Diagnostic Radiological Services have a copay of up to $300, Therapeutic Radiological Services have a coinsurance of at most 20% and a copay of up to $35, and Outpatient X-Ray Services have no copay and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the HumanaChoice Florida H7284-008 (PPO) 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 by the HumanaChoice Florida H7284-008 (PPO) plan, but the specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice Florida H7284-008 (PPO), with no copay for days 1-20, and a $160 copay 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 no copay, but is limited to 25 treatments per year and requires prior authorization. Over-the-counter items, meal benefits, 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.
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