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HumanaChoice R0110-007 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-007 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-007 (Regional PPO) in 2025, please refer to our full plan details page.
HumanaChoice R0110-007 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in States of Pennsylvania and West Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that HumanaChoice R0110-007 (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 R0110-007 (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 R0110-007 (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 $5900.00 (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 $5900.00 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
Prescription drugs are not covered by HumanaChoice R0110-007 (Regional PPO).
Additional Benefits
The HumanaChoice R0110-007 (Regional PPO) plan offers a wide array of benefits with varying costs. Inpatient hospital stays have a copay of $350 for the first few days, with no copay thereafter. Outpatient services, including primary care, have copays ranging from $0 to $350. This plan also includes coverage for emergency services, preventive services like annual checkups with no copay, and dental, hearing, and vision services. Additional benefits include ambulance services, home health services with no copay, and coverage for medical equipment with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you'll pay a $350 copay for days 1-5, and no copay for days 6-90, and for Inpatient Hospital Psychiatric, you'll pay a $350 copay for days 1-4, and no copay for days 5-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999, 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 include coverage for all outpatient hospital services, with copays ranging from $0 to $350, observation services with a $350 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have copays between $35 and $85 for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the HumanaChoice R0110-007 (Regional PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and air ambulance services have a $270 copay, while transportation services to a plan-approved health-related location have no copay for up to 24 one-way trips per year, and 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 by the HumanaChoice R0110-007 (Regional PPO) plan. Emergency Services have a $90 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 $90 copay and no coinsurance.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a copay between $20 and $35, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a $35 copay, Other Health Care Professional services with a copay between $0 and $35, Psychiatric Services with a $35 copay, Physical Therapy and Speech-Language Pathology Services with a copay between $20 and $35, Additional Telehealth Benefits with a copay between $0 and $55, and Opioid Treatment Program Services with a copay between $35 and $85. Routine Chiropractic Care is not covered, and Podiatry Services are not covered.
Preventive Services See details
The HumanaChoice R0110-007 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services, like wigs for hair loss related to chemotherapy, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, are covered with no copay.
Hearing Services See details
HumanaChoice R0110-007 (Regional PPO) covers hearing exams with a $35 copay, routine hearing exams once per year with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $199 and $499, and OTC hearing aids are covered up to $35 per month.
Vision Services See details
Vision Services includes eye exams with a copay of $0-$35, with a maximum benefit of $40 per year. Eyewear is covered with a combined maximum of $300 per year, and contact lenses and eyeglasses are covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The HumanaChoice R0110-007 (Regional PPO) plan covers dental services, including a $35 copay for Medicare dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services have no copay. Restorative services, prosthodontics, and implant services have a 30-40% coinsurance, while prosthodontics (removable) and implant services have a 30% coinsurance. Maxillofacial prosthetics and fluoride treatment are not covered, and orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the HumanaChoice R0110-007 (Regional PPO) plan and require prior authorization. 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 by the HumanaChoice R0110-007 (Regional PPO) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and prior authorization required, and Prosthetics/Medical Supplies with 20% coinsurance; Diabetic Equipment is covered with 10% coinsurance and a $0 copay for Diabetic Supplies, and a 10% copay for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The HumanaChoice R0110-007 (Regional PPO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $300, and Therapeutic Radiological Services have a copay of up to $35 and coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R0110-007 (Regional PPO) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required and copays apply, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice R0110-007 (Regional PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $178 copay for days 21-100, with no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
HumanaChoice R0110-007 (Regional PPO) covers acupuncture with a $35 copay, up to 20 treatments per year, and also provides over-the-counter items with a monthly maximum of $35. The plan also covers a meal benefit with no copay. However, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and other services are not covered.
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