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HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Southeast Florida. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP).
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 SNP-DE H7284-010 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 $8950.00 (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 $8950.00 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 SNP-DE H7284-010 (PPO D-SNP)
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Drug Coverage
The HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when filled at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 and Tier 2 drugs carry a copay of up to $20 for a one-month supply. For Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance across all pharmacy and mail order options. This consistent coinsurance rate applies to both one-month and three-month supplies where available. Understanding these copay and coinsurance costs helps you plan your healthcare budget with this HumanaChoice Florida D-SNP.
Additional Benefits
The HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan offers comprehensive medical coverage, featuring primary care, specialist visits, and preventive care with no copay and no coinsurance. Inpatient hospital stays require a $1,000 copay per admission with no coinsurance, while outpatient hospital services range from no copay up to a $35 copay with a 20% coinsurance. Emergency room visits are subject to a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides valuable supplemental benefits, including routine dental, vision, and hearing care with no copay and no coinsurance up to annual allowance limits. Additionally, members can access home health care and unlimited transportation to approved medical locations with no copay or coinsurance. Skilled nursing facility stays are covered with no copay for the first 20 days, and extra benefits like acupuncture, meals, and over-the-counter items are also available at no cost.
Inpatient Hospital See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,000 copay per admission and no coinsurance, though prior authorization is required. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers outpatient hospital services with a $0 to $35 copay and 20% coinsurance, and ambulatory surgical center services with no copay and 20% coinsurance. Outpatient substance abuse services require no coinsurance and a $0 to $35 copay, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers partial hospitalization benefits with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering unlimited one-way trips to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services require a $130 copay and no coinsurance.
Primary Care See details
Primary care benefits under HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) include primary care, specialist, mental health, and podiatry visits with no copay and no coinsurance, while chiropractic services are not covered. Physical, occupational, and speech therapies require no copay and 20% coinsurance, and telehealth and opioid treatment services feature copays up to $40 with no coinsurance.
Preventive Services See details
Preventive services are partially covered by HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) with no copay and no coinsurance for covered benefits, including annual physical exams, kidney disease education, and glaucoma screenings. While select additional benefits like in-home support and chemotherapy wigs (up to $500 annually) are covered, services such as health education, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) with no copay and no coinsurance for routine exams, fitting evaluations, and hearing aids. Up to two prescription or OTC hearing aids are covered every three years with a $3,600 maximum limit, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) partially covers vision services with no copay, no coinsurance, and no deductible for covered benefits, though prior authorization is required. The plan covers one annual routine eye exam and up to $500 yearly for contact lenses or eyeglasses, while other eye exams, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) offers partially covered dental services with no copay and no coinsurance for covered benefits, up to a combined in- and out-of-network annual maximum of $1,250. While preventive and comprehensive options like exams, cleanings, and surgeries are covered, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers home infusion bundled services with prior authorization and step therapy, requiring a 0% to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Other Part B drugs have no copay, while covered Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic equipment and supplies are covered with no copay and no coinsurance, though prior authorization is required and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers diagnostic and radiological services, which require prior authorization and a 20% coinsurance. While diagnostic procedures and tests have a copay ranging from $0 to $40, there is no copay for lab services, outpatient X-rays, and therapeutic or diagnostic radiological services.
Home Health Services See details
Home Health Services are covered under the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers some cardiac rehabilitation services, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered in practice. Covered services require prior authorization and feature no copay and a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $185 copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) with no copay and no coinsurance, offering acupuncture limited to 25 treatments per year, over-the-counter items, and meal benefits. Highly integrated services and some CMS OTC list drugs are not covered.
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