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HumanaChoice R0110-013 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-013 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-013 (Regional PPO) in 2025, please refer to our full plan details page.
HumanaChoice R0110-013 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Michigan. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that HumanaChoice R0110-013 (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 R0110-013 (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 R0110-013 (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 $6750.00 (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 $6750.00 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 R0110-013 (Regional PPO)
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Drug Coverage
Prescription drugs are not covered by HumanaChoice R0110-013 (Regional PPO).
Additional Benefits
The HumanaChoice R0110-013 (Regional PPO) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay, outpatient services, and emergency services. Primary care visits, preventive services like annual physical exams, and hearing exams have no copay, while vision and dental services are also covered with varying cost-sharing. The plan also covers home infusion, dialysis, home health services, and skilled nursing facility stays. This plan covers a broad array of services with varying cost-sharing arrangements. Diagnostic and radiological services have copays up to $350, while ambulance services have a $250 copay. Other services like hearing aids, dental, and medical equipment have coverage, but some services and supplies are not covered, such as eyewear upgrades, home safety devices, and additional days for inpatient hospital psychiatric.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $295 copay for days 1-6 and a $0 copay for days 7-90 for acute care, and a $295 copay for days 1-5 and a $0 copay for days 6-90 for psychiatric care. Additional days for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $270, and observation services with a $295 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have a copay between $20 and $65 for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services have a $250 copay, but there is 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 by the HumanaChoice R0110-013 (Regional PPO) plan. Emergency Services have a $90 copay, Urgently Needed Services have a $55 copay, and Worldwide Emergency Services have a $90 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with no copay, Occupational Therapy Services with a $10-$40 copay, Physician Specialist Services with a $30 copay, and Mental Health Specialty Services with a $20 copay. Additionally, this plan covers Other Health Care Professional services with a $0-$30 copay, Psychiatric Services with a $20 copay, Physical Therapy and Speech-Language Pathology Services with a $10-$40 copay, Additional Telehealth Benefits with a $0-$55 copay, and Opioid Treatment Program Services with a $20-$65 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The HumanaChoice R0110-013 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit are also covered with no copay. The plan also covers wigs for hair loss related to chemotherapy and fitness benefits with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $30 copay, and routine hearing exams have no copay. Fitting/evaluation for hearing aids has no copay. Prescription hearing aids (all types) have a copay between $399 and $999, while prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are also not covered.
Vision Services See details
The HumanaChoice R0110-013 (Regional PPO) plan covers vision services, including eye exams with a copay of $0-$30 and eyewear with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a $1,000 annual maximum benefit. Medicare Dental Services have a $30 copay, while Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, and Prosthodontics (fixed) have no copay. Fluoride Treatment, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with prior authorization. You will pay a $35 copay for Medicare Part B Insulin Drugs, with coinsurance between 0% and 19% for all covered drugs.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice R0110-013 (Regional PPO) plan, with a coinsurance of 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no coinsurance and no copay, Prosthetics/Medical Supplies with a 19% coinsurance, and Diabetic Equipment with varying cost-sharing depending on the specific service. 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 and a maximum copay of $95 for diagnostic procedures/tests, and no copay for lab services. Diagnostic radiological services have a copay of at most $350, while therapeutic radiological services have a coinsurance of at most 20%, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R0110-013 (Regional PPO) plan with no copay and no coinsurance, though Additional Hours of Care and Personal Care Services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific sub-services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice R0110-013 (Regional PPO), with no copay for days 1-20, and a $178 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The HumanaChoice R0110-013 (Regional PPO) plan covers acupuncture with a $30 copay and a limit of 20 treatments per year, and meal benefits with no copay. Over-the-counter items, 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, 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.
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