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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 2025, 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 2025.
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 $128.00. 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 $480.00 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 $14000.00 (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 $14000.00 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 has a $480 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy used. For example, in the initial coverage phase, you will pay $18 for preferred generic drugs at a standard or mail-order pharmacy. For preferred brand drugs, you will pay 50% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Humana Full Access R0110-005 (Regional PPO) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a $110 copay. You'll also find coverage for primary care with no copay, preventive services with no copay, and routine hearing exams with no copay. This plan provides additional benefits like vision services, dental services, home infusion, and medical equipment with varying cost-sharing. It also covers skilled nursing facility stays with a copay, and offers other services such as acupuncture and a meal benefit, but it is important to note that prior authorization may be required for some services.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you will pay a $399 copay for days 1-6, and no copay for days 7-90, and no copay for days 91-999. For Inpatient Hospital Psychiatric, you will pay a $399 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
The Humana Full Access R0110-005 (Regional PPO) plan covers outpatient services, including outpatient hospital services with a copay between $0 and $460, observation services with a $399 copay, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services are covered with copays between $45 and $100 for individual and group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Full Access R0110-005 (Regional PPO) plan, with an $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services have a $315 copay, with no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Humana Full Access R0110-005 (Regional PPO) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a $45 copay, but both have no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all have a $110 copay and no coinsurance.
Primary Care See details
The Humana Full Access R0110-005 (Regional PPO) plan covers Primary Care Physician services with no copay, Chiropractic Services with a $15 copay, and Occupational Therapy Services with a $25 copay. The plan also covers Physician Specialist Services with a $50 copay, Mental Health Specialty Services with a copay of $45, Physical Therapy and Speech-Language Pathology Services with a $25 copay, and Additional Telehealth Benefits with a copay between $0 and $50. Additionally, Opioid Treatment Program Services have a copay between $45 and $100.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, with no copay. Annual physical exams are covered with no copay, and additional preventive services are covered, but the cost sharing may vary. Other preventive services like Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
The Humana Full Access R0110-005 (Regional PPO) plan covers hearing exams with a $50 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a copay between $699 and $999, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Humana Full Access R0110-005 (Regional PPO) plan covers vision services, including eye exams with a copay between $0 and $50, and eyewear with no copay. This plan does not cover eyeglass lenses, eyeglass frames, or upgrades.
Dental Services See details
The Humana Full Access R0110-005 (Regional PPO) plan covers Medicare dental services with a $50 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay. However, fluoride treatment, restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the Humana Full Access R0110-005 (Regional PPO) plan, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with varying cost-sharing depending on the specific supply or service. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Humana Full Access R0110-005 (Regional PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $120, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $325, and Therapeutic Radiological Services have a copay up to $50 and a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Full Access R0110-005 (Regional PPO) plan 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 covered under the Humana Full Access R0110-005 (Regional PPO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, while for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Humana Full Access R0110-005 (Regional PPO) plan covers acupuncture with a $50 copay, and a meal benefit with no copay. Other services such as over-the-counter items, dual eligible SNPs with highly integrated services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and more are not covered.
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