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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 2025, 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 out of 5 stars in 2025.
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 $20.30. 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 $590.00 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:
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Drug Coverage
The HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), the plan's premium is $20.30. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan offers a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a $1,000 copay per admission, while outpatient services often have a 20% coinsurance. Emergency services have a $105 copay, and primary care visits have a $0 copay. Preventive services, including annual physical exams, have no copay. The plan also includes coverage for hearing, vision, and dental services with no copay for exams and cleanings. The plan also has added benefits for home infusion services and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan, with a $1,000 copay per admission or stay for Medicare-covered stays. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital-Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with 20% coinsurance and no copay, observation services with 20% coinsurance, ambulatory surgical center services with 20% coinsurance and no copay, outpatient substance abuse services with 20% coinsurance and no copay, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, with up to 50 one-way trips per year available via taxi, bus/subway, or medical transport. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan. Emergency Services have a $105 copay and no coinsurance, while Urgently Needed Services have a $55 copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $105 copay and no coinsurance.
Primary Care See details
Under the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan, Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services has a $0 copay and Occupational Therapy Services have a 20% coinsurance and a $0 copay. Physical Therapy and Speech-Language Pathology Services have a 20% coinsurance and no copay. Additional Telehealth Benefits have a copay between $0 and $55, while Opioid Treatment Program Services have a 20% coinsurance and a $0 copay. Other services have a $0 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams with no copay, additional preventive services, kidney disease education services, and other preventive services, though some services require a copay. Other covered services include wigs for hair loss related to chemotherapy, In-Home Support Services, Additional Sessions of Smoking and Tobacco Cessation Counseling, and Fitness Benefits, all with no copay.
Hearing Services See details
Hearing exams, including routine hearing exams and fitting/evaluation for hearing aids, are covered with no copay. Prescription hearing aids are covered with a maximum plan benefit coverage of $3600 every three years, and OTC hearing aids are covered with a maximum of $3600 every three years and no copay. The plan does not cover prescription hearing aids for the inner ear, outer ear, or over the ear.
Vision Services See details
Vision services include eye exams and eyewear, with a $0 copay for eye exams, contact lenses, and eyeglasses (lenses and frames). Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, all with a $0 copay. The plan does not cover fluoride treatment, maxillofacial prosthetics, implants, or orthodontics. There is a $2,000 maximum plan benefit coverage amount per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and between 0% and 20% coinsurance. Other Medicare Part B drugs have no copay and between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic procedures/tests have a copay of up to $60 and a coinsurance of at most 20%, while lab services and outpatient X-rays have no copay and a coinsurance of at most 20%. Diagnostic and therapeutic radiological services have no copay and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) 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 not covered by the HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP) plan. This includes services such as Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. There is no copay for days 1-20, and a $185.50 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has no copay, and OTC items have a maximum benefit coverage amount of $1620 per year, while the meal benefit has no copay. 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, 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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