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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 2026, 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 2026.
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) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, members pay predictable copays, such as $20 to $35 for specialist visits and $130 for emergency room care, while inpatient hospital stays require a $350 daily copay for the first few days before transitioning to no copay. Outpatient services and diagnostic lab tests are highly accessible, with many services requiring no copay and no coinsurance. This plan also provides robust supplemental benefits, including routine dental, vision, and hearing services with no copay, alongside a generous $4,000 annual limit for dental care. Additionally, members can access up to 24 one-way transportation trips per year and receive over-the-counter items with no copay or coinsurance. Durable medical equipment and dialysis services are covered with no copay and a standard 20% coinsurance, ensuring affordable management of long-term health needs.
Inpatient Hospital See details
HumanaChoice R0110-007 (Regional PPO) covers inpatient hospital services with no coinsurance, although prior authorization is required. For acute stays, there is a $350 daily copay for days 1 through 5 and no copay for days 6 and beyond, while psychiatric stays require a $350 daily copay for days 1 through 4 and no copay for days 5 through 90. Non-Medicare-covered stays and upgrades are not covered under these benefits.
Outpatient Services See details
HumanaChoice R0110-007 (Regional PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $375 ($350 for observation services), and outpatient substance abuse sessions have a $35 copay, with prior authorization required for these services.
Partial Hospitalization See details
Partial hospitalization is covered by HumanaChoice R0110-007 (Regional PPO) with a $35.00 copay and no coinsurance. Prior authorization is required to receive these benefits.
Ambulance and Transportation Services See details
HumanaChoice R0110-007 (Regional PPO) covers ground and air ambulance services with a $270 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice R0110-007 (Regional PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are available with a $130 copay and no coinsurance.
Primary Care See details
Primary care benefits under the HumanaChoice R0110-007 (Regional PPO) are covered with no copay and no coinsurance for primary care provider visits, while specialist, mental health, and therapy services require copays ranging from $20 to $35 and no coinsurance. Additional telehealth services feature a $0 to $50 copay with no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
HumanaChoice R0110-007 (Regional PPO) partially covers preventive services with no copay and no coinsurance for covered benefits, including annual physical exams, kidney disease education, diabetes self-management training, glaucoma screenings, fitness benefits, and chemotherapy-related wigs up to $500 annually. However, several supplemental services, such as health education, weight management programs, and nutritional benefits, are not covered.
Hearing Services See details
HumanaChoice R0110-007 (Regional PPO) covers Medicare-covered hearing exams with a $35 copay and routine exams or fitting evaluations with no copay, all with no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a $199 to $499 copay for up to two aids per year, excluding inner ear, outer ear, and over the ear types. Over-the-counter hearing aids are also covered with no copay and no coinsurance.
Vision Services See details
HumanaChoice R0110-007 (Regional PPO) partially covers vision services, featuring one annual routine eye exam with no copay and no coinsurance, up to a $40 limit. Covered eyewear, including one annual pair of contact lenses or eyeglasses, also has no copay and no coinsurance up to a $300 limit, while other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R0110-007 (Regional PPO) dental services are partially covered up to a $4,000 annual limit, with no copay and no coinsurance for most preventive and comprehensive care, a $35 copay and no coinsurance for Medicare-covered dental, and a 30% coinsurance with no copay for removable prosthodontics. Fluoride treatments, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R0110-007 (Regional PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs range from no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
HumanaChoice R0110-007 (Regional PPO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HumanaChoice R0110-007 (Regional PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay and a 10% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice R0110-007 (Regional PPO) with prior authorization, featuring no copay or coinsurance for lab services and a $0 to $95 copay with no coinsurance for diagnostic tests. Diagnostic radiological services start at a $0 copay, outpatient X-rays have no copay but may require coinsurance, and therapeutic radiological services require a minimum $35 copay and 20% coinsurance.
Home Health Services See details
HumanaChoice R0110-007 (Regional PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice R0110-007 (Regional PPO) with no coinsurance and required prior authorization. However, in practice, some services are covered while cardiac and intensive cardiac rehabilitation (each with a $35 copay), and pulmonary and SET for PAD services (each with a $10 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice R0110-007 (Regional PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, prior inpatient hospital stays of less than three days are allowed, and additional days beyond the standard 100 days are not covered.
Other Services See details
HumanaChoice R0110-007 (Regional PPO) covers other services including acupuncture with a $35 copay and no coinsurance for 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, and other miscellaneous services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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