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HumanaChoice R0110-004 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-004 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-004 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R0110-004 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in North Carolina and Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice R0110-004 (Regional PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HumanaChoice R0110-004 (Regional 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 R0110-004 (Regional 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.
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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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 R0110-004 (Regional PPO)
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Drug Coverage
Prescription drugs are not covered by HumanaChoice R0110-004 (Regional PPO).
Additional Benefits
The HumanaChoice R0110-004 (Regional PPO) plan offers comprehensive medical coverage with no copay for primary care visits and routine preventive services. For specialized care, members pay a $45 copay for specialist visits, while inpatient hospital stays require a $375 daily copay for the first five days and no copay for days six through 90. Emergency room visits carry a $115 copay, which is waived if you are admitted, and urgent care services are available with a $40 copay. This plan also features valuable everyday benefits, including dental, vision, and hearing care with no copay for routine annual exams, alongside a $1,500 annual limit for covered dental services. Home health services are fully covered with no copay, while skilled nursing facility stays require no copay for the first 20 days. Essential durable medical equipment is covered with a 20% coinsurance and no copay, helping you manage ongoing healthcare costs.
Inpatient Hospital See details
HumanaChoice R0110-004 (Regional PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $375 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while unlimited additional acute days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice R0110-004 (Regional PPO) covers outpatient services with no coinsurance, featuring a $0 to $395 copay for outpatient hospital services and a $375 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by HumanaChoice R0110-004 (Regional PPO) with a $35.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
HumanaChoice R0110-004 (Regional PPO) provides partial coverage for ambulance and transportation services, offering ground and air ambulance services for a $335 copay per trip and no coinsurance. Prior authorization is required for ambulance services, while transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
HumanaChoice R0110-004 (Regional PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are all covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice R0110-004 (Regional PPO) offers primary care physician visits with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Covered physical, occupational, speech therapy, and mental health services require copays between $25 and $35 with no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by HumanaChoice R0110-004 (Regional PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, memory fitness, and various screenings. However, additional preventive benefits are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home/bathroom safety modifications, and counseling services.
Hearing Services See details
HumanaChoice R0110-004 (Regional PPO) covers hearing exams with no coinsurance and a $45 copay for Medicare-covered exams, while routine annual exams and fittings have no copay. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 (inner ear, outer ear, and over-the-ear models are not covered), whereas over-the-counter (OTC) hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered under HumanaChoice R0110-004 (Regional PPO) with no deductibles, featuring routine eye exams with no copay and no coinsurance up to a $40 yearly limit, while other eye exams are not covered. Covered eyewear includes contact lenses and eyeglasses with no copay and no coinsurance up to a $350 annual limit, though upgrades, separate eyeglass lenses, and separate frames are not covered.
Dental Services See details
HumanaChoice R0110-004 (Regional PPO) offers partially covered dental services with no copay and no coinsurance for most preventive and comprehensive care, up to a $1,500 annual maximum. Medicare-covered dental services require a $45 copay and no coinsurance, while fluoride treatments, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R0110-004 (Regional PPO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice R0110-004 (Regional PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice R0110-004 (Regional PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice R0110-004 (Regional PPO) with prior authorization, featuring no copay for lab services and outpatient X-rays. Diagnostic procedures and tests carry a copay ranging from $0 to $120 with no coinsurance, while therapeutic radiological services require a 20% coinsurance and a minimum copay of $45.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R0110-004 (Regional PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the HumanaChoice R0110-004 (Regional PPO) plan, but prior authorization is required. Although some services are covered, standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy for symptomatic peripheral artery disease services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice R0110-004 (Regional PPO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 copay for days 21 to 100, while additional days beyond Medicare coverage are not covered. Prior authorization is required, and a prior three-day inpatient hospital stay is not required.
Other Services See details
HumanaChoice R0110-004 (Regional PPO) partially covers other services, offering acupuncture with a $45 copay and no coinsurance up to 20 treatments per year, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, while other miscellaneous services and highly integrated Dual Eligible SNPs are not covered.
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