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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 2026, 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 3.5 out of 5 stars in 2026.
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 $39.00. 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 $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) Medicare plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay when filled at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also highly affordable, costing a $5 copay for a one-month supply at standard pharmacies and preferred mail order, and dropping to no copay for a three-month preferred mail order supply. For brand-name and specialty medications, Tier 3 preferred brands cost a $47 copay for a one-month supply, with a slightly reduced $131 copay for a three-month supply via preferred mail order. Tier 4 non-preferred drugs require a 37% coinsurance across all pharmacy and mail order options. Finally, Tier 5 specialty drugs require a 25% coinsurance for a one-month supply at both standard pharmacies and mail order services.
Additional Benefits
The HumanaChoice Florida H7284-008 (PPO) plan offers comprehensive medical coverage with no copay for primary care doctor visits and a $35 copay for specialist visits. For hospital stays, members pay a $415 daily copay for the first seven days of inpatient care, followed by no copay for additional days, while outpatient hospital visits range from no copay up to a $315 copay. Emergency room visits carry a $150 copay, which is waived if you are admitted within 24 hours, and urgent care is available with a $15 copay. Routine dental cleanings, annual eye exams, and routine hearing evaluations are all covered with no copay, though annual maximum benefit limits apply to eyewear and prescription hearing aids. Home health services and the first 20 days of skilled nursing facility care also require no copay, while durable medical equipment and dialysis services require a 20% coinsurance. This plan balances robust routine care with predictable copays and coinsurance to help you manage your healthcare budget.
Inpatient Hospital See details
HumanaChoice Florida H7284-008 (PPO) covers inpatient acute hospital stays with no coinsurance and a $415 daily copay for days 1 to 7, with no copay for day 8 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $415 daily copay for days 1 to 5, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by HumanaChoice Florida H7284-008 (PPO) with no coinsurance across all services, though prior authorization is required. Patients pay no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital visits have a $0 to $315 copay, observation services require a $415 copay per stay, and outpatient substance abuse sessions carry a $30 to $35 copay.
Partial Hospitalization See details
HumanaChoice Florida H7284-008 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are offered by HumanaChoice Florida H7284-008 (PPO), covering ground ambulance services with a $120 to $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and routine transportation services to health-related locations are not covered.
Emergency Services See details
HumanaChoice Florida H7284-008 (PPO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $15 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available for a $150 copay and no coinsurance.
Primary Care See details
HumanaChoice Florida H7284-008 (PPO) primary care benefits include primary care physician services with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Therapy services require a $10 to $35 copay with no coinsurance, while podiatry is not covered, and chiropractic benefits cover some services although routine and other chiropractic services are not covered.
Preventive Services See details
HumanaChoice Florida H7284-008 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits, such as annual physical exams and kidney disease education. However, additional preventive services—including fitness benefits, health education, personal emergency response systems, and nutritional therapy—are not covered.
Hearing Services See details
HumanaChoice Florida H7284-008 (PPO) hearing services are partially covered, featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids—excluding inner ear, outer ear, and over the ear types—and over-the-counter hearing aids are covered with no copay and no coinsurance, limited to two hearing aids every three years with a $1,000 maximum benefit for prescription aids.
Vision Services See details
HumanaChoice Florida H7284-008 (PPO) vision services are partially covered, offering one routine eye exam and either one pair of eyeglasses or contact lenses per year with no copay, no coinsurance, and no deductible. Annual maximum benefits of $75 for exams and $200 for eyewear apply, while other eye exam services, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
HumanaChoice Florida H7284-008 (PPO) offers partially covered dental services, with Medicare-covered dental requiring a $35 copay and no coinsurance, and preventive benefits like cleanings and exams available with no copay and no coinsurance. Non-covered services include fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, while adjunctive general services are covered with no copay and no coinsurance.
Home Infusion bundled Services See details
HumanaChoice Florida H7284-008 (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs have no coinsurance to 20% coinsurance, while covered insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
HumanaChoice Florida H7284-008 (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 H7284-008 (PPO) covers durable medical equipment (DME), prosthetics, and diabetic supplies with a 20% coinsurance and no copay. Diabetic therapeutic shoes and inserts are covered with a $5 copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the HumanaChoice Florida H7284-008 (PPO) plan, requiring prior authorization and generally carrying a minimum 20% coinsurance. While lab services, outpatient X-rays, and diagnostic radiological services have no copay, therapeutic radiological services require a minimum $35 copay, and diagnostic procedures and tests range from no copay up to a $200 copay.
Home Health Services See details
Home Health Services are covered by HumanaChoice Florida H7284-008 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice Florida H7284-008 (PPO) with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
HumanaChoice Florida H7284-008 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $160 copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HumanaChoice Florida H7284-008 (PPO) partially covers other services, offering acupuncture with no copay and no coinsurance for up to 25 treatments per year with prior authorization required. Supplemental benefits such as over-the-counter (OTC) items and meal benefits are not covered.
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