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HumanaChoice R0110-016 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R0110-016 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R0110-016 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R0110-016 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Ohio. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice R0110-016 (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 R0110-016 (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 R0110-016 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $80.00. 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 $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 $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 R0110-016 (Regional PPO) Medicare plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share. Understanding this initial cost is essential when evaluating if this regional PPO plan fits your healthcare budget and prescription needs. Specific drug coverage tier details, including individual copayments and coinsurance rates for different medication levels, are currently unavailable for this plan. To get a complete picture of your potential medication costs, you may want to contact the plan provider directly to verify how your specific prescriptions are covered. This step ensures you avoid unexpected expenses and find the most cost-effective Medicare drug coverage.
Additional Benefits
The HumanaChoice R0110-016 (Regional PPO) plan offers comprehensive medical coverage featuring no copays for primary care visits, preventive services, and home health care. Specialist visits require a $40 copay, while inpatient hospital stays incur a daily copay of $475 for the first few days before transitioning to no copay. Emergency services are available with a $115 copay, which is waived upon hospital admission. This plan also provides robust supplemental benefits, including dental coverage up to $2,000 and routine hearing and vision exams with no copays. Prescription hearing aids require copays ranging from $499 to $1,099, while medical equipment and dialysis services generally require a 20% coinsurance. Additionally, members benefit from no copays on over-the-counter items, select meals, and lab services.
Inpatient Hospital See details
HumanaChoice R0110-016 (Regional PPO) covers inpatient hospital services with no coinsurance, requiring a $475 daily copay for days 1 through 5 of an acute stay and days 1 through 4 of a psychiatric stay, with no copay for subsequent days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice R0110-016 (Regional PPO) covers outpatient services with no coinsurance, featuring a $0 to $530 copay for outpatient hospital services and a $475 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by HumanaChoice R0110-016 (Regional PPO) with a $35 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HumanaChoice R0110-016 (Regional PPO) covers Medicare-covered ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HumanaChoice R0110-016 (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, and worldwide emergency, urgent, and transportation services are available for a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice R0110-016 (Regional PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $40 copay and no coinsurance. Additional services like physical, occupational, and mental health therapies have copays ranging from $15 to $40 with no coinsurance, but for chiropractic care, some services are covered while routine and other chiropractic services are not.
Preventive Services See details
HumanaChoice R0110-016 (Regional PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits, including annual physical exams, kidney disease education, select screenings, and memory fitness. However, several supplemental services are not covered, such as health education, weight management programs, in-home safety assessments, and nutritional/dietary benefits.
Hearing Services See details
Hearing services are covered by HumanaChoice R0110-016 (Regional PPO), featuring no copay and no coinsurance for routine hearing exams, fitting evaluations, and OTC hearing aids. Medicare-covered exams require a $40 copay with no coinsurance, while prescription hearing aids are partially covered with a $499 to $1099 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
HumanaChoice R0110-016 (Regional PPO) vision services are partially covered with no coinsurance, no deductibles, no copay for covered eyewear, and no copay to a $40 copay for eye exams. One routine eye exam and one pair of contact lenses or eyeglasses (lenses and frames) are covered annually under plan limits, while other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice R0110-016 (Regional PPO), featuring a $2,000 annual maximum for preventive and comprehensive services with no copay and no coinsurance. Medicare-covered dental services require a $40 copay and no coinsurance, while fluoride treatments, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R0110-016 (Regional PPO) covers Home Infusion bundled services with no copay, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs require 0% to 20% coinsurance, while Medicare Part B insulin drugs carry a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
HumanaChoice R0110-016 (Regional PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
HumanaChoice R0110-016 (Regional PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice R0110-016 (Regional PPO) covers diagnostic and radiological services, with diagnostic services requiring no coinsurance, no copay for lab services, and a $0 to $110 copay for procedures. Radiological services feature no copay for outpatient X-rays, copays starting at $0 for diagnostic radiology, and a minimum 20% coinsurance and $50 copay for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by HumanaChoice R0110-016 (Regional PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice R0110-016 (Regional PPO) with no coinsurance and a $15 copay, meaning some services are covered, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by HumanaChoice R0110-016 (Regional PPO) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required and a prior three-day hospital stay is not needed, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice R0110-016 (Regional PPO) covers acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, subject to prior authorization. Over-the-counter (OTC) items and limited-duration meal benefits are also covered with no copay and no coinsurance, though the meal benefit requires prior authorization.
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