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Humana Full Access R0110-005 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Full Access R0110-005 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Full Access R0110-005 (Regional PPO) in 2026, please refer to our full plan details page.
Humana Full Access R0110-005 (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 Humana Full Access R0110-005 (Regional 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 Humana Full Access R0110-005 (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 Humana Full Access R0110-005 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $117.00. 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 $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:
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Drug Coverage
The Humana Full Access R0110-005 (Regional PPO) plan features an annual prescription 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 or through preferred mail order. Tier 2 generic drugs carry a low $5 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay required for a 3-month supply filled via preferred mail order. Tier 3 preferred brand drugs cost a $47 copay for a 1-month supply, while a 3-month supply costs $131 through preferred mail order and $141 at standard pharmacies. Tier 4 non-preferred drugs require a 34% coinsurance, and Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply. Understanding these copays and coinsurance rates helps you maximize your savings with this Humana Regional PPO plan.
Additional Benefits
The Humana Full Access R0110-005 (Regional PPO) plan offers robust coverage for essential medical needs, featuring no copay for primary care visits and a $45 copay for specialist consultations. For hospital stays, inpatient acute care requires a $375 daily copay for the first seven days and no copay thereafter, while emergency room visits carry a $115 copay that is waived upon admission. Most outpatient services and home health care are covered with no coinsurance, and many diagnostic services feature no copay. This plan also includes valuable dental, vision, and hearing benefits, offering routine exams and preventive dental care with no copay. Additionally, skilled nursing facility stays have no copay for the first 20 days, while durable medical equipment and dialysis services generally require a 20% coinsurance. Covered eyewear is also included with no copay up to a $150 annual limit, making this a comprehensive option for managing everyday healthcare costs.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Full Access R0110-005 (Regional PPO) with no coinsurance, though prior authorization is required. Medicare-covered acute stays require a $375 copay for days 1 to 7 and no copay for days 8 and beyond, while psychiatric stays require a $375 copay for days 1 to 5 and no copay for days 6 to 90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Full Access R0110-005 (Regional PPO) covers outpatient services with no coinsurance, though prior authorization is required for most care. Ambulatory surgical center and outpatient blood services feature no copay, while outpatient hospital services range from no copay to a $450 copay ($375 for observation services), and outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Humana Full Access R0110-005 (Regional PPO) plan with a $35 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Humana Full Access R0110-005 (Regional PPO) covers Medicare-covered ground and air ambulance services with a $335 copay per service and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Humana Full Access R0110-005 (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 require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Full Access R0110-005 (Regional PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Additional covered services include physical, occupational, and speech therapies for a $25 copay, mental health and psychiatric sessions for a $35 copay, and telehealth for a $0 to $45 copay, all with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Humana Full Access R0110-005 (Regional PPO) with no copay and no coinsurance for covered services like annual physicals, kidney disease education, select screenings, and a memory fitness benefit. However, several additional preventive services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Full Access R0110-005 (Regional PPO) covers hearing services with no coinsurance and no deductibles, featuring a $45 copay for Medicare-covered exams and no copay for routine annual exams and fitting evaluations. Prescription hearing aids are partially covered with a copay ranging from $699 to $999 for up to two aids per year, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Humana Full Access R0110-005 (Regional PPO) partially covers vision services, featuring eye exams with a $0 to $45 copay and no coinsurance, and covered eyewear with no copay and no coinsurance up to a $150 annual limit. Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Full Access R0110-005 (Regional PPO) dental services are partially covered, offering preventive and most comprehensive care with no copay and no coinsurance, while Medicare-covered dental requires a $45.00 copay and no coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Full Access R0110-005 (Regional PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by the Humana Full Access R0110-005 (Regional PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Full Access R0110-005 (Regional PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copayment. Diabetic supplies are covered with a 10% to 20% coinsurance and no copayment, while diabetic therapeutic shoes and inserts require a $10 copayment and coinsurance.
Diagnostic and Radiological Services See details
Humana Full Access R0110-005 (Regional PPO) covers diagnostic and radiological services, with prior authorization required for these benefits. Lab services, diagnostic radiology, and outpatient X-rays feature no copay and no coinsurance, while diagnostic procedures have a $0 to $120 copay with no coinsurance, and therapeutic radiological services require a $45 copay and 20% coinsurance.
Home Health Services See details
Humana Full Access R0110-005 (Regional PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Full Access R0110-005 (Regional PPO) with no coinsurance, but require prior authorization. While some services are covered, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered, although they list copays ranging from $20.00 to $30.00.
Skilled Nursing Facility (SNF) See details
Humana Full Access R0110-005 (Regional PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Full Access R0110-005 (Regional PPO), which includes acupuncture for a $45.00 copay and no coinsurance (up to 20 treatments per year) and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for both covered services, while over-the-counter (OTC) items are not covered.
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