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HumanaChoice R1532-002 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R1532-002 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R1532-002 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R1532-002 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in States of Arkansas and Missouri. This plan received an overall rating of 2.5 out of 5 stars in 2026.
It's important to know that HumanaChoice R1532-002 (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 R1532-002 (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 R1532-002 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.00. 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 has a $100.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 R1532-002 (Regional PPO) offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. For individuals who qualify for the low-income subsidy, also known as Extra Help, the monthly Part D premium is reduced from $50.00 to $21.50. During the initial coverage phase, Tier 1 preferred generics cost a $5.00 copay at standard pharmacies and preferred mail order, while Tier 2 standard generics require a $47.00 copay. Tier 3 preferred brands have a 36% coinsurance, and Tier 4 non-preferred drugs carry a 25% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs.
Additional Benefits
The HumanaChoice R1532-002 (Regional PPO) plan offers comprehensive medical coverage featuring no copay for primary care physician visits and Medicare-covered preventive services. For inpatient hospital stays, members pay a daily copay of $460 for days 1 through 5, with no copay or coinsurance starting on day 6. Emergency care is available with a $115 copay, which is waived upon admission, while specialist visits require copays ranging from $15 to $55. This plan also includes key supplemental benefits, including routine dental and vision exams with no copay, alongside a $1,500 annual dental limit. Routine hearing exams are provided with no copay, and up to two prescription hearing aids are covered per year with copays between $699 and $999. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HumanaChoice R1532-002 (Regional PPO) partially covers inpatient hospital services, excluding non-Medicare-covered stays and upgrades for acute care, and additional days and non-Medicare-covered stays for psychiatric care. For acute stays, there is a $460 daily copay for days 1 to 5 and no copay or coinsurance for days 6 and beyond. Psychiatric stays require a $405 daily copay for days 1 to 5 and no copay or coinsurance for days 6 to 90.
Outpatient Services See details
HumanaChoice R1532-002 (Regional PPO) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services and a $460 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copay, while outpatient substance abuse sessions require a $30 to $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by HumanaChoice R1532-002 (Regional PPO) with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
HumanaChoice R1532-002 (Regional PPO) partially covers Ambulance and Transportation Services, as transportation to plan-approved and any health-related locations is not covered. Covered ground ambulance services require a $335 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required.
Emergency Services See details
Emergency services are covered by HumanaChoice R1532-002 (Regional PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services carry a $115 copay and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered under the HumanaChoice R1532-002 (Regional PPO) plan, featuring no copay for primary care physician visits and copays ranging from $15 to $55 for specialists, therapy, and mental health services with no coinsurance. Podiatry services and routine chiropractic care are not covered.
Preventive Services See details
HumanaChoice R1532-002 (Regional PPO) partially covers preventive services, offering Medicare-covered preventive care, annual physical exams, kidney education, and select screenings with no copay and no coinsurance. Additional preventive services are not covered.
Hearing Services See details
HumanaChoice R1532-002 (Regional PPO) partially covers hearing services with no deductibles or coinsurance, offering Medicare-covered exams for a $55 copay and annual routine exams and fitting evaluations with no copay. Up to two prescription hearing aids (all types) are covered per year with a $699 to $999 copay, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HumanaChoice R1532-002 (Regional PPO) covers routine eye exams with no copay and no coinsurance, up to a $75 annual limit, while other eye exams require a copay of up to $55. Eyewear is partially covered with no copay and no coinsurance up to a $100 yearly limit, but individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R1532-002 (Regional PPO) offers partially covered dental services with an annual maximum of $1,500, excluding fluoride, implants, maxillofacial prosthetics, and orthodontics. Medicare dental services require a $55 copay, while diagnostic and preventive care have no copay. Covered restorative and prosthodontic services have no copay and 30% to 40% coinsurance, while endodontic, periodontic, and oral surgery services have no copay and no coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HumanaChoice R1532-002 (Regional PPO) with prior authorization, featuring a $35 copay and up to 20% coinsurance (starting at no coinsurance) for Part B insulin. Other covered Part B drugs, including chemotherapy and radiation, require no copay and carry a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice R1532-002 (Regional PPO) with 20% coinsurance and no copay. Prior authorization is required to receive these services.
Medical Equipment See details
HumanaChoice R1532-002 (Regional PPO) covers durable medical equipment and prosthetic devices with a 20% coinsurance, with no copay required for durable medical equipment. Medical supplies require a 20% coinsurance, while diabetic supplies have a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under HumanaChoice R1532-002 (Regional PPO) with prior authorization required, featuring no copay for lab services and outpatient X-rays. Diagnostic tests require a 25% coinsurance and up to a $55 copay, diagnostic radiological services have a copay up to $335, and therapeutic radiological services require a 20% coinsurance and a $35 to $45 copay.
Home Health Services See details
HumanaChoice R1532-002 (Regional PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by HumanaChoice R1532-002 (Regional PPO) with prior authorization required, though only some services are covered since cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by HumanaChoice R1532-002 (Regional PPO), requiring prior authorization and featuring no copay for days 1 to 20, a $218 daily copay for days 21 to 100, and no coinsurance. Additional days beyond Medicare-covered SNF stays are not covered.
Other Services See details
HumanaChoice R1532-002 (Regional PPO) partially covers Other Services, as Over-the-Counter items and Dual Eligible SNPs are not covered. Covered acupuncture services require a $55 copay and no coinsurance, while chronic illness meal benefits are provided with no copay and no coinsurance.
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