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HumanaChoice R4182-001 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R4182-001 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R4182-001 (Regional PPO) in 2025, please refer to our full plan details page.
HumanaChoice R4182-001 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in State of Texas. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that HumanaChoice R4182-001 (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 R4182-001 (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 R4182-001 (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 $8950.00 (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 $8950.00 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
Prescription drugs are not covered by HumanaChoice R4182-001 (Regional PPO).
Additional Benefits
The HumanaChoice R4182-001 (Regional PPO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a $125 copay. You'll have access to primary care with a $5 copay, preventive services with no copay, and coverage for hearing, vision, and dental services, each with specific copays and annual maximums. The plan also covers ambulance services, home health services with no copay, and various therapies with copays. Additionally, it includes benefits for home infusion, medical equipment, and diagnostic services with copays or coinsurance, along with other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered under the HumanaChoice R4182-001 (Regional PPO) plan. For days 1-5 of an Inpatient Hospital-Acute or Inpatient Hospital Psychiatric stay, there is a $345 copay, and for days 6-90, there is no copay; additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days 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 with a copay between $40 and $450, observation services with a $345 copay, and ambulatory surgical center (ASC) services with a $245 copay. Outpatient substance abuse services have a copay between $30 and $50 for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the HumanaChoice R4182-001 (Regional PPO) plan, with a $35 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $315 copay, while air ambulance services have 20% coinsurance. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the HumanaChoice R4182-001 (Regional PPO) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a $55 copay and no coinsurance, and Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, each have a $125 copay and no coinsurance.
Primary Care See details
The HumanaChoice R4182-001 (Regional PPO) plan covers primary care physician services with a $5 copay, chiropractic services with a $20 copay (prior authorization required), occupational therapy services with a $25 copay, physician specialist services with a $40 copay, individual and group mental health and psychiatric sessions with a $30 copay, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a copay between $0 and $55, and opioid treatment program services with a copay between $30 and $50 (prior authorization required). Routine Chiropractic Care and Podiatry services are not covered.
Preventive Services See details
The HumanaChoice R4182-001 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services covered include Medicare-covered glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
The HumanaChoice R4182-001 (Regional PPO) plan covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered; Prescription Hearing Aids (all types) have a copay between $699 and $999. OTC hearing aids are covered with a maximum benefit of $45 every three months.
Vision Services See details
The HumanaChoice R4182-001 (Regional PPO) plan covers vision services, including eye exams with a copay between $0 and $40, and eyewear with no copay, and a combined maximum of $250 per year for both in-network and out-of-network services; however, eyeglass lenses, eyeglass frames, and upgrades are not covered. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered.
Dental Services See details
The HumanaChoice R4182-001 (Regional PPO) plan covers Medicare Dental Services with a $40 copay, and other dental services including 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 oral and maxillofacial surgery, all with no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), and Orthodontics are not covered. The plan has a maximum benefit of $2500 per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0% and 20%, while other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice R4182-001 (Regional PPO) plan and require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered under the HumanaChoice R4182-001 (Regional PPO) plan. Durable Medical Equipment (DME) has a 15% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 15% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Supplies have a coinsurance between 10% and 20%, with no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic, radiological, and outpatient x-ray services are covered. Diagnostic Procedures/Tests have a copay between $5 and $60, and a coinsurance of at most 50%, while Lab Services have no copay. Diagnostic Radiological Services have a copay between $40 and $300, and Therapeutic Radiological Services have a copay of at most $40 and a coinsurance of at most 20%. Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R4182-001 (Regional PPO) plan with no copay and no coinsurance; however, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit, but specific cost-sharing details are not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the HumanaChoice R4182-001 (Regional PPO) plan, with a prior authorization required. For days 1-20, the copay is $10, and for days 21-100, the copay is $214; additional and non-Medicare-covered SNF days are not covered.
Other Services See details
Under "Other Services," HumanaChoice R4182-001 (Regional PPO) covers acupuncture with a $40 copay, and up to 20 treatments per year, as well as over-the-counter items with a $45 benefit every three months. The plan also covers a meal benefit with no copay. However, services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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