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HumanaChoice Florida H7284-009 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Florida H7284-009 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Florida H7284-009 (PPO) in 2025, please refer to our full plan details page.
HumanaChoice Florida H7284-009 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in North and Rural Florida. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that HumanaChoice Florida H7284-009 (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 H7284-009 (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 H7284-009 (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 $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 $350.00 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 $8900.00 (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 $8900.00 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 H7284-009 (PPO) plan has a $350 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, for a standard pharmacy, you will pay a $5 copay for preferred generic drugs, and a 40% coinsurance for preferred brand drugs. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The HumanaChoice Florida H7284-009 (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services with varying copays and coinsurance. It also covers emergency services, primary care, preventive services, and home health services with no copay, while specialist visits have a $35 copay. Additional benefits include coverage for hearing, vision, and dental services with copays and maximum annual benefits. The plan also provides coverage for ambulance, partial hospitalization, and various therapies.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $355 copay for days 1-5, and no copay for days 6-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you will pay a $355 copay for days 1-5, and no copay for days 6-90. 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 20% coinsurance and a copay between $0 and $315, Observation Services with a $355 copay, and Ambulatory Surgical Center Services with no copay. Outpatient Substance Abuse Services for individual and group sessions have a coinsurance of 20% and a copay between $35 and $35. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the HumanaChoice Florida H7284-009 (PPO) plan, but requires prior authorization. You will have a $45 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the HumanaChoice Florida H7284-009 (PPO) plan. Ground ambulance services have a copay of $120-$240, while air ambulance services have a 20% coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, and no coinsurance. Urgently Needed Services have a $15 copay, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $125 copay, and no coinsurance.
Primary Care See details
The HumanaChoice Florida H7284-009 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $10-$35 copay, and specialist services with a $35 copay. Mental health specialty services and psychiatric services have a $30 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $10-$35 copay, and additional telehealth benefits range from no copay to a $35 copay. Opioid treatment program services have a 20% coinsurance and a $35 copay.
Preventive Services See details
The HumanaChoice Florida H7284-009 (PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services are partially covered, but health education, in-home safety assessments, and other services are not covered.
Hearing Services See details
Hearing services are partially covered by the HumanaChoice Florida H7284-009 (PPO) plan, with a $35 copay for hearing exams, but routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids (all types, inner ear, outer ear, and over the ear) are not covered. OTC hearing aids are also not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, and a maximum plan benefit of $75 per year. Eyewear is covered with no copay, up to a combined maximum of $200 per year for contact lenses, and eyeglasses (lenses and frames), but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered under the HumanaChoice Florida H7284-009 (PPO) plan, with a $1,000 maximum benefit. Medicare Dental Services require a $35 copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventative dental services are covered with no copay. Fluoride treatments, 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, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice Florida H7284-009 (PPO) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 16% coinsurance and no copay, and Prosthetics/Medical Supplies with no copay and a 20% coinsurance. Diabetic Equipment is covered, and Diabetic Supplies have a 20% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for all diagnostic services with a coinsurance, Diagnostic Procedures/Tests with a coinsurance of at most 20% and a maximum copayment of $200, and Lab Services with no copay. Therapeutic Radiological Services have a coinsurance of at most 20% and a copay of at most $45, while Diagnostic Radiological Services have a maximum copay of $275. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice Florida H7284-009 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with prior authorization, but the plan does not specify the copay or coinsurance. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice Florida H7284-009 (PPO) plan. There is no copay for days 1-20, and a $160 copay for days 21-100.
Other Services See details
The HumanaChoice Florida H7284-009 (PPO) plan covers acupuncture with no copay, but requires prior authorization and is limited to 25 treatments per year. Other services such as over-the-counter items, meal benefits, and several others are not covered.
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