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HumanaChoice R0110-012 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-012 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-012 (Regional PPO) in 2025, please refer to our full plan details page.
HumanaChoice R0110-012 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Indiana and Kentucky. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that HumanaChoice R0110-012 (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 R0110-012 (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 R0110-012 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.10. 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 $245.00 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 HumanaChoice R0110-012 (Regional PPO) plan has a $245 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, for preferred generic drugs, you will pay a $10 copay at preferred pharmacies and mail order, or a $20 copay at standard pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs.
Additional Benefits
The HumanaChoice R0110-012 (Regional PPO) plan offers coverage for a variety of services. Inpatient hospital stays have a copay, while outpatient services and preventive services may have no copay. The plan covers primary care, vision, and dental services with varying copays. Additionally, it offers benefits for hearing, home health, and other services, as well as coverage for ambulance and emergency services, with specific copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered. For Inpatient Hospital-Acute, you will pay a $470 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a $470 copay for days 1-4, and no copay for days 5-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $470, Observation Services have a $470 copay, and Ambulatory Surgical Center Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a copay between $45 and $90, while Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the HumanaChoice R0110-012 (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 by the HumanaChoice R0110-012 (Regional PPO) plan. Ground and air ambulance services have a $315 copay, and there is 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 HumanaChoice R0110-012 (Regional PPO) plan. Emergency Services have a $110 copay and no coinsurance, while Urgently Needed Services have a $45 copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay and no coinsurance.
Primary Care See details
The HumanaChoice R0110-012 (Regional PPO) plan covers primary care physician services for a $5 copay, chiropractic services for a $15 copay, occupational therapy services for a $35 copay, physician specialist services for a $55 copay, mental health specialty services with a $45 copay, physical therapy and speech-language pathology services for a $35 copay, additional telehealth benefits with a copay between $0 and $55, and opioid treatment program services with a copay between $45 and $90. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The HumanaChoice R0110-012 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing Services include hearing exams with a $55 copay, routine hearing exams with no copay for one exam per year, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) have a copay between $499 and $799 for two hearing aids every year, while OTC hearing aids are covered with a maximum benefit of $15 every month. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The HumanaChoice R0110-012 (Regional PPO) plan covers vision services including eye exams with a copay between $0 and $55. Eyewear is covered with no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The HumanaChoice R0110-012 (Regional PPO) plan covers dental services, including Medicare Dental Services with a $55 copay and other dental services with a $1,000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services are covered with no copay, while fluoride treatment, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered. Restorative services are covered with a $25 copay, and adjunctive general services are covered with no copay.
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%. For all other drugs listed, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the HumanaChoice R0110-012 (Regional PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The HumanaChoice R0110-012 (Regional PPO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance, and it also covers Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Supplies have a 10% to 20% coinsurance with no copay, and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a minimum copay of $0 for Diagnostic Procedures/Tests and a maximum copay of $105, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $720, Therapeutic Radiological Services have a maximum copay of $40 and 20% coinsurance, and Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice R0110-012 (Regional PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the HumanaChoice R0110-012 (Regional PPO) plan, but the specific services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit, and more details regarding the copay can be found in the plan documents.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice R0110-012 (Regional PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF, and Non-Medicare-covered stays are not covered.
Other Services See details
The HumanaChoice R0110-012 (Regional PPO) plan covers acupuncture with a $55 copay, but requires prior authorization and is limited to 20 treatments per year. Over-the-counter items are covered with a maximum benefit coverage amount of $15.00 per month. Other services such as meal benefits, and many additional services are not covered.
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