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HumanaChoice R4182-003 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R4182-003 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R4182-003 (Regional PPO) in 2025, please refer to our full plan details page.
HumanaChoice R4182-003 (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 R4182-003 (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 R4182-003 (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 R4182-003 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $138.00. 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 $275.00 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 $10300.00 (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 $10300.00 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 R4182-003 (Regional PPO) plan has a $275 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you may pay a $10 copay for preferred generic drugs at a standard pharmacy. For preferred brand drugs, you will pay 46% coinsurance, and for non-preferred drugs, you will pay 29% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The HumanaChoice R4182-003 (Regional PPO) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a copay, and outpatient services like primary care and specialist visits have copays ranging from $20 to $50. Emergency services have a $110 copay. Preventive services, routine eye exams, and many dental services have no copay. The plan also covers hearing exams and hearing aids with copays, and offers coverage for vision and dental services. Other benefits include ambulance services with copays or coinsurance, and coverage for home health services and skilled nursing facilities.
Inpatient Hospital See details
The HumanaChoice R4182-003 (Regional PPO) plan covers Inpatient Hospital-Acute services with a copay of $390 for days 1-6, and no copay for days 7-90; Inpatient Hospital Psychiatric services have a copay of $339 for days 1-6, and no copay for days 7-90. Non-Medicare-covered stays and upgrades for both services are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay of $45-$350, observation services with a copay of $390, ambulatory surgical center (ASC) services with a copay of $250, and outpatient substance abuse services with a copay of $30-$100 for individual and group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial hospitalization is covered by the HumanaChoice R4182-003 (Regional PPO) plan, with a $45 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $315 copay, while air ambulance services have a 20% coinsurance. 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. For Emergency Services, there is a $110 copay and no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Urgently Needed Services have a $45 copay and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $110 copay and no coinsurance.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with a $20 copay. Chiropractic Services are covered with a $15 copay, but routine care is not covered. Occupational Therapy Services have a $25 copay. Physician Specialist Services have a $50 copay. Mental Health Specialty Services have a $30 copay for both individual and group sessions. Physical Therapy and Speech-Language Pathology Services have a $25 copay. Additional Telehealth Benefits have a copay between $0 and $50. Opioid Treatment Program Services have a copay between $30 and $100.
Preventive Services See details
The HumanaChoice R4182-003 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including fitness benefits, are covered with no copay.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $50 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $699 and $999. Prescription hearing aids for inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear, with some services not usually covered by Medicare plans. Eye exams have a copay between $0 and $50, and routine eye exams have no copay; however, eyeglass lenses, eyeglass frames, and upgrades are not covered. Eyewear has no copay and a combined maximum benefit of $150 every year.
Dental Services See details
The HumanaChoice R4182-003 (Regional PPO) plan covers Medicare Dental Services with a $50 copay, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), and Other Preventive Dental Services with no copay. Fluoride Treatment, Restorative Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the HumanaChoice R4182-003 (Regional PPO) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
The HumanaChoice R4182-003 (Regional PPO) plan covers Medical Equipment, including Durable Medical Equipment (DME) with a 15% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have a coinsurance between 10% and 20% with no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay between $0 and $100, Lab Services with no copay, Diagnostic Radiological Services with a copay between $40 and $325, Therapeutic Radiological Services with a copay of at most $40 and coinsurance of at most 20%, and Outpatient X-Ray Services with a $20 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the HumanaChoice R4182-003 (Regional PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice R4182-003 (Regional PPO), but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice R4182-003 (Regional PPO), but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
Other Services includes acupuncture and a meal benefit. Acupuncture has a $50 copay and requires prior authorization, while the meal benefit has no copay and requires prior authorization, as well. Some other services, such as over-the-counter items, are not covered.
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