A non-government entity
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 2026, 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 Greater North Florida. This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 $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 $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:
Sign up for HumanaChoice Florida H7284-009 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HumanaChoice Florida H7284-009 (PPO) Medicare prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order, while standard mail order costs up to $30. Tier 2 generic medications cost a low $5 copay for a 1-month supply at standard pharmacies, with no copay required for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, with 3-month supplies costing $131 through preferred mail order and $141 at standard pharmacies. Tier 4 non-preferred drugs carry a 47% coinsurance for 1-month and 3-month supplies across standard pharmacies and mail order options. Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply through standard pharmacies and mail order services.
Additional Benefits
The HumanaChoice Florida H7284-009 (PPO) plan offers robust coverage with no copay or coinsurance for primary care physician visits, home health care, and annual preventive physicals. Specialist visits and Medicare-covered dental services require a $35 copay with no coinsurance. For hospital stays, members pay a $355 daily copay for the first five days of inpatient care, after which there is no copay for days 6 through 90. Additional benefits include dental coverage with a $1,000 annual maximum and no copay for preventive services, alongside routine vision and hearing exams with no copay. Prescription hearing aids are covered with no copay up to a $1,000 limit every three years, and select eyewear is covered up to $200 annually with no copay. Most medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
HumanaChoice Florida H7284-009 (PPO) covers inpatient hospital services with no coinsurance, requiring a $355 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, while unlimited additional acute care days are covered with no copay.
Outpatient Services See details
HumanaChoice Florida H7284-009 (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $315, outpatient substance abuse sessions have a $30 to $35 copay, and outpatient observation services require a $355 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by HumanaChoice Florida H7284-009 (PPO) with a $35.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
HumanaChoice Florida H7284-009 (PPO) covers ground ambulance services with a $120.00 to $240.00 copay and coinsurance, and air ambulance services with a 20% coinsurance and a copay, both requiring prior authorization. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Emergency services are covered by HumanaChoice Florida H7284-009 (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $15 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice Florida H7284-009 (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. Other covered services like physical therapy, mental health, and telehealth range from no copay up to a $35 copay with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by HumanaChoice Florida H7284-009 (PPO), featuring annual physicals, kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and EKGs with no copay and no coinsurance. However, additional benefits such as fitness programs, health education, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are covered by HumanaChoice Florida H7284-009 (PPO), which offers Medicare-covered exams for a $35 copay and no coinsurance, alongside annual routine exams, fittings, and OTC hearing aids with no copays or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum every three years, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice Florida H7284-009 (PPO), offering routine eye exams and select eyewear with no copay and no coinsurance. While one routine exam (up to $75 annually) and one pair of eyeglasses or contact lenses (up to $200 annually) are covered with prior authorization, other eye exams, standalone eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice Florida H7284-009 (PPO), offering up to a $1,000 annual maximum benefit for combined in- and out-of-network care. Covered preventive, diagnostic, and adjunctive services have no copay and no coinsurance, while Medicare-covered dental has a $35 copay and restorative services require a $25 copay, both with no coinsurance. Fluoride, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HumanaChoice Florida H7284-009 (PPO) with no copay, though prior authorization and step therapy may apply. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HumanaChoice Florida H7284-009 (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 H7284-009 (PPO) covers medical equipment, including 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 no coinsurance, and prior authorization is required for most of these benefits.
Diagnostic and Radiological Services See details
HumanaChoice Florida H7284-009 (PPO) covers diagnostic and radiological services with prior authorization, offering diagnostic radiological services with no copay and no coinsurance. Lab services and outpatient X-rays have no copays but may carry coinsurance, while diagnostic procedures range from no copay up to a $200 copay with a minimum 20% coinsurance, and therapeutic radiology requires a minimum $35 copay and a minimum 20% coinsurance.
Home Health Services See details
HumanaChoice Florida H7284-009 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by HumanaChoice Florida H7284-009 (PPO) with no copay and no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice Florida H7284-009 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $160 copay for days 21 through 100, and additional days beyond the Medicare limit are not covered.
Other Services See details
HumanaChoice Florida H7284-009 (PPO) partially covers other services, providing acupuncture with no copay and no coinsurance for up to 25 treatments per year with prior authorization. Over-the-counter (OTC) items, meal benefits, and other additional services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved