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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 2025, 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 2025.
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 $27.00. 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 $590.00 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 $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 R0110-016 (Regional PPO) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your prescriptions. Once your total drug costs reach $2,000, you will enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The HumanaChoice R0110-016 (Regional PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay depending on the length of stay, while outpatient services have copays ranging from $0 to $475. Emergency services and primary care visits have copays, while preventive services and many dental services are covered with no copay. The plan also includes coverage for hearing and vision services, with copays for some services. Additional benefits include ambulance services, home health, and skilled nursing facilities, each with their own cost structures. The plan also covers some home infusion, dialysis, and medical equipment services, with a coinsurance for many of these services.
Inpatient Hospital See details
Inpatient Hospital services, including Acute and Psychiatric, are covered under the HumanaChoice R0110-016 (Regional PPO) plan, with a copay of $475 for days 1-5 and no copay for days 6-90 for Acute, and a copay of $475 for days 1-4 and no copay for days 5-90 for Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional days for Inpatient Hospital Psychiatric and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $475, while Observation Services have a $475 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Individual and Group Sessions for Outpatient Substance Abuse have a copay between $45 and $95.
Partial Hospitalization See details
Partial Hospitalization is covered under this 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 HumanaChoice R0110-016 (Regional PPO). Ground and Air Ambulance services have a $300 copay, and 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 R0110-016 (Regional PPO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay, while Urgently Needed Services has a $45 copay, with no coinsurance for any of these services.
Primary Care See details
The HumanaChoice R0110-016 (Regional PPO) plan offers Primary Care services with no copay for Primary Care Physician Services, a $15 copay for Chiropractic Services, and a $15-$35 copay for Physical Therapy and Speech-Language Pathology Services. The plan also includes a $40 copay for Physician Specialist Services, and Mental Health Specialty Services with a $40 copay for both individual and group sessions.
Preventive Services See details
Preventive services include no copay for an annual physical exam, and no copay for Medicare-covered preventive services. Additional preventive services, kidney disease education services, and other preventive services have a copay, but the specific amount is not listed.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $40 copay and routine hearing exams with no copay for 1 visit every year, as well as fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, but the inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a maximum of $100 every three months.
Vision Services See details
The HumanaChoice R0110-016 (Regional PPO) plan covers vision services, including eye exams and eyewear. Eye exams have a copay between $0 and $40, while routine eye exams, contact lenses, and eyeglasses (lenses and frames) have no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a $2,500 annual maximum benefit. Medicare Dental Services have a $40 copay, while oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The plan covers Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the HumanaChoice R0110-016 (Regional PPO) plan. This plan requires prior authorization, and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Supplies have a 10-20% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with some services requiring prior authorization. Diagnostic Procedures/Tests have a maximum copay of $110, and Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $350, while Therapeutic Radiological Services have a maximum copay of $50 and a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R0110-016 (Regional PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice R0110-016 (Regional PPO), but the specific services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice R0110-016 (Regional PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100, and additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The HumanaChoice R0110-016 (Regional PPO) plan covers acupuncture with a $40 copay, up to 20 treatments per year, and requires prior authorization. This plan also covers Over-the-Counter (OTC) items, including nicotine replacement therapy, with a maximum benefit of $100 every three months. Meal benefits are covered with no copay, and require prior authorization. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and other services.
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