A non-government entity
HumanaChoice R0110-008 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-008 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-008 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R0110-008 (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 R0110-008 (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 HumanaChoice R0110-008 (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 R0110-008 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $52.00. 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 has a $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $10000.00 (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 $10000.00 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 R0110-008 (Regional PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HumanaChoice R0110-008 (Regional PPO) Medicare prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies or through preferred mail order, while standard mail order costs $10 for a one-month supply. Tier 2 generic drugs cost $5 for a one-month supply at standard pharmacies and preferred mail order, and you pay no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply across standard pharmacies and mail order services. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. These structured costs help you plan your healthcare budget when choosing standard pharmacies or mail-order options.
Additional Benefits
The HumanaChoice R0110-008 (Regional PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care physician visits, preventive care, and home health services. For emergency care, members pay a $130 copay with no coinsurance, which is waived if they are admitted to the hospital within 24 hours. Inpatient hospital stays also feature no coinsurance but require a $350 daily copay for the first five days of acute care. Routine dental, vision, and hearing exams are highly accessible with no copays and no coinsurance under this plan. For specialty medical needs, specialist visits and acupuncture require a $45 copay with no coinsurance, while durable medical equipment and dialysis services require a 20% coinsurance with no copay. Skilled nursing facility care is also covered with no coinsurance, featuring a low $10 daily copay for the first 20 days.
Inpatient Hospital See details
HumanaChoice R0110-008 (Regional PPO) partially covers inpatient hospital services with no coinsurance, featuring a $350 daily copay for days 1 through 5 of acute stays and days 1 through 4 of psychiatric stays, followed by no copay for additional covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice R0110-008 (Regional PPO) covers outpatient services with no coinsurance, though prior authorization is required for these services. Patients pay no copay for ambulatory surgical center and blood services, a $35 copay for outpatient substance abuse sessions, a $350 copay per stay for observation services, and a copay ranging from $0 to $690 for outpatient hospital services.
Partial Hospitalization See details
HumanaChoice R0110-008 (Regional PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
HumanaChoice R0110-008 (Regional PPO) covers ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HumanaChoice R0110-008 (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, while worldwide emergency, urgent care, and emergency transportation are all covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice R0110-008 (Regional PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits for a $45 copay and no coinsurance. Physical, occupational, and speech therapies require a $20 to $40 copay with no coinsurance, while mental health and psychiatric sessions cost a $35 copay with no coinsurance. Podiatry is not covered, and for chiropractic services, some services are covered but routine and other chiropractic services are not.
Preventive Services See details
HumanaChoice R0110-008 (Regional PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. While some services are covered under additional preventive benefits, specific options like fitness programs, health education, nutritional therapy, and in-home support are not covered.
Hearing Services See details
HumanaChoice R0110-008 (Regional PPO) partially covers hearing services with no deductible and no coinsurance, offering one routine hearing exam and unlimited fitting evaluations per year with no copay, while Medicare-covered exams require a $45 copay. Up to two prescription hearing aids are covered annually with a $699 to $999 copay, but OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HumanaChoice R0110-008 (Regional PPO) offers partially covered vision services with no coinsurance and no deductible, featuring no copay for routine eye exams and covered eyewear. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R0110-008 (Regional PPO) provides partially covered dental services, featuring a $45 copay and no coinsurance for Medicare-covered dental services, and no copay and no coinsurance for most other covered preventive and comprehensive dental services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R0110-008 (Regional PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy and other Part B drugs are covered with no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HumanaChoice R0110-008 (Regional PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice R0110-008 (Regional PPO), with durable medical equipment, prosthetics, and medical supplies requiring a 20% coinsurance and no copay. Diabetic supplies feature a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice R0110-008 (Regional PPO) covers diagnostic and radiological services, offering lab services with no copay and no coinsurance, and diagnostic tests with a $0 to $105 copay and no coinsurance. Diagnostic radiological services have no copay, while therapeutic radiological services require a minimum $45 copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by HumanaChoice R0110-008 (Regional PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under HumanaChoice R0110-008 (Regional PPO), as standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
HumanaChoice R0110-008 (Regional PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required for admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice R0110-008 (Regional PPO) partially covers other services, offering acupuncture for a $45 copay and no coinsurance, alongside a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved