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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 2026, 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 2026.
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 $20.00. 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.
This plan has a $350.00 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 $13900.00 (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 $13900.00 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) Medicare prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay for a 3-month supply filled via preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply, while a 3-month supply costs $131 through preferred mail order and $141 through standard pharmacies or standard mail order. For higher tiers, Tier 4 non-preferred drugs require 46% coinsurance, and Tier 5 specialty drugs require 29% coinsurance for a 1-month supply. This drug coverage structure offers predictable copays for common medications while utilizing coinsurance for specialized treatments.
Additional Benefits
HumanaChoice R0110-012 (Regional PPO) offers comprehensive coverage with no copay for primary care visits and a $55 copay for specialist visits. Inpatient hospital stays require a $470 daily copay for the first few days and no copay thereafter, while emergency room visits carry a $115 copay that is waived upon admission. Outpatient services generally feature no coinsurance, with copays ranging from no copay up to $470 depending on the specific procedure. Preventive care, routine eye exams, and routine hearing tests are available with no copay, though prescription hearing aids require copays up to $899 and eyewear has defined coverage limits. Dental benefits include no copay for preventive services and a $25 copay for restorative care, up to a $1,000 annual maximum. Additionally, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HumanaChoice R0110-012 (Regional PPO) covers inpatient hospital services with no coinsurance, requiring a $470 daily copay for days 1 to 5 of an acute stay and days 1 to 4 of a psychiatric stay, followed by no copay for remaining covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
HumanaChoice R0110-012 (Regional PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital and observation services have copays ranging from $0 to $470, while outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
HumanaChoice R0110-012 (Regional PPO) covers partial hospitalization with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
HumanaChoice R0110-012 (Regional PPO) partially covers ambulance and transportation services, offering Medicare-covered ground and air ambulance services with a $335 copay and no coinsurance. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
HumanaChoice R0110-012 (Regional PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Primary care benefits under HumanaChoice R0110-012 (Regional PPO) are covered with no copay and no coinsurance for primary care visits, and a $55 copay with no coinsurance for specialist visits. Therapy services and mental health sessions generally require a $35 copay with no coinsurance, while podiatry is not covered and chiropractic services are only partially covered (routine and other chiropractic services are not covered).
Preventive Services See details
HumanaChoice R0110-012 (Regional PPO) covers preventive services, including annual physicals, kidney disease education, diabetes self-management, glaucoma screenings, and memory fitness, with no copay and no coinsurance. However, these benefits are only partially covered, excluding health education, PERS, in-home safety assessments, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, telemonitoring, and home safety modifications.
Hearing Services See details
HumanaChoice R0110-012 (Regional PPO) covers Medicare-covered hearing exams with a $55 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids have no copay and no coinsurance. Prescription hearing aids are partially covered with a $599 to $899 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
HumanaChoice R0110-012 (Regional PPO) features partially covered vision services with no copay, no coinsurance, and no deductible, though prior authorization is required. Covered services include one routine eye exam (up to $75 yearly) and contact lenses or eyeglasses (up to a combined $100 yearly), while other eye exams, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R0110-012 (Regional PPO) offers partially covered dental services with a $1,000 annual maximum, featuring no copay and no coinsurance for preventive services, a $25 copay and no coinsurance for restorative services, and a $55 copay and no coinsurance for Medicare dental services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R0110-012 (Regional PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs require coinsurance ranging from no coinsurance up to 20%, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis services are covered by HumanaChoice R0110-012 (Regional PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice R0110-012 (Regional PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies and services are also covered, requiring a 10% to 20% coinsurance and copays ranging from no copay to $10.
Diagnostic and Radiological Services See details
HumanaChoice R0110-012 (Regional PPO) covers diagnostic and radiological services with prior authorization, featuring no copay for lab services and outpatient X-rays. Diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $105, while therapeutic radiological services require a minimum 20% coinsurance and a minimum $40 copay.
Home Health Services See details
Home Health Services are covered by HumanaChoice R0110-012 (Regional PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under HumanaChoice R0110-012 (Regional PPO) with a $15 copay, no coinsurance, and prior authorization requirements. Although some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice R0110-012 (Regional PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not needed, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other services under HumanaChoice R0110-012 (Regional PPO) are partially covered, featuring acupuncture for a $55 copay and no coinsurance, alongside over-the-counter items and chronic illness meals with no copay and no coinsurance. Specific supplemental benefits, including Dual Eligible SNP services, are not covered.
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