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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 2025, 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 2025.
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 $63.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
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:
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Drug Coverage
The HumanaChoice R0110-008 (Regional PPO) plan has an "Enhanced Alternative" drug benefit. This plan has no deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $20 copay for preferred generic drugs at standard and mail-order pharmacies. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The HumanaChoice R0110-008 (Regional PPO) plan offers a range of benefits, including inpatient hospital stays with a $350 copay for the first few days, and no copay thereafter. Outpatient services, primary care, preventive services, and dental services have varying copays, with some services like annual physical exams and cleanings offered with no copay. The plan also includes coverage for hearing and vision services, ambulance, emergency services, and home health services, each with its own specific cost structure.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $350 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you 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 a copay between $0 and $690, observation services with a $350 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $40 and $95 for individual and group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the HumanaChoice R0110-008 (Regional PPO) plan. Ground and Air Ambulance Services have a $315 copay, with no coinsurance, while 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 HumanaChoice R0110-008 (Regional PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $55 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $125 copay.
Primary Care See details
The HumanaChoice R0110-008 (Regional PPO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services and chiropractic services have a $15 copay, physician specialist services have a $45 copay, occupational therapy services have a $20-$40 copay, mental health specialty services, including individual and group sessions, have a $40 copay, other health care professional services have a $15-$45 copay, psychiatric services, including individual and group sessions, have a $40 copay, physical therapy and speech-language pathology services have a $20-$40 copay, additional telehealth benefits have a $0-$55 copay, and opioid treatment program services have a $40-$95 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The HumanaChoice R0110-008 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Additionally, this plan covers glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and an EKG following a Welcome Visit, all with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with a $45 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are partially covered, but inner ear, outer ear, and over the ear hearing aids are not covered; the plan has a $699-$999 copay for prescription hearing aids (all types). OTC hearing aids are not covered.
Vision Services See details
The HumanaChoice R0110-008 (Regional PPO) plan covers vision services, including eye exams with a copay of $0-$45 and eyewear with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The HumanaChoice R0110-008 (Regional PPO) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services with no copay. Medicare dental services require a $45 copay. Fluoride treatments, restorative services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the HumanaChoice R0110-008 (Regional PPO) plan. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice R0110-008 (Regional PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered under HumanaChoice R0110-008 (Regional PPO). Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have a 10% coinsurance with no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $105, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $300, Therapeutic Radiological Services have a copay of at most $45 and coinsurance of at most 20%, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R0110-008 (Regional PPO) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the HumanaChoice R0110-008 (Regional PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the HumanaChoice R0110-008 (Regional PPO) plan, but require prior authorization. For days 1-20, the copay is $10, and for days 21-100, the copay is $214; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include acupuncture, with a $45 copay, and a meal benefit with no copay; however, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Acupuncture has a limit of 20 treatments per year.
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