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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 2026, 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 2026.
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 $97.00. 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 R4182-003 (Regional PPO) plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and preferred mail order. Tier 2 generic drugs are also highly affordable, with a $5 copay for a 1-month supply and no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs cost a $47 copay for a 1-month supply, while a 3-month supply ranges from $131 to $141 depending on your pharmacy selection. Tier 4 non-preferred drugs require a 35% coinsurance for both 1-month and 3-month supplies. Tier 5 specialty tier drugs carry a 25% coinsurance for a 1-month supply through standard pharmacies and mail order.
Additional Benefits
The HumanaChoice R4182-003 (Regional PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, and preventive services. For specialized medical care, members will pay a $50 copay for specialist visits, while emergency room visits carry a $115 copay that is waived if admitted. Inpatient hospital stays require daily copays for the first six days, which are $390 per day for acute care and $339 per day for psychiatric care, with no copay for subsequent days. Routine vision and hearing exams, along with preventive dental care, are available with no copay and no coinsurance under this plan. For medical equipment and dialysis services, members can expect a 20% coinsurance with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a daily copay of $218 for days 21 through 100.
Inpatient Hospital See details
HumanaChoice R4182-003 (Regional PPO) inpatient hospital services are partially covered with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. For acute care, there is a $390 copay per day for days 1-6 and no copay for days 7 and beyond, while psychiatric care requires a $339 copay per day for days 1-6 and no copay for days 7-90.
Outpatient Services See details
HumanaChoice R4182-003 (Regional PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $390 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $30 to $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the HumanaChoice R4182-003 (Regional PPO) plan with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HumanaChoice R4182-003 (Regional PPO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
HumanaChoice R4182-003 (Regional PPO) covers emergency services with a $115 copay and no coinsurance, with the copay 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 are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice R4182-003 (Regional PPO) covers primary care physician visits and telehealth services with no copay and no coinsurance, while specialist visits require a $50 copay and therapy services require a $25 copay with no coinsurance. Mental health, psychiatric, and opioid treatment services have copays ranging from $30 to $35 with no coinsurance, whereas podiatry and chiropractic services are not covered.
Preventive Services See details
HumanaChoice R4182-003 (Regional PPO) offers partially covered preventive services with no copay and no coinsurance for covered care, including annual physical exams, kidney disease education, diabetes self-management training, and a fitness benefit. However, several supplemental services, such as health education, in-home safety assessments, and nutritional benefits, are not covered under this plan.
Hearing Services See details
HumanaChoice R4182-003 (Regional PPO) covers Medicare-covered hearing exams with a $50 copay and no coinsurance, while routine hearing exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay between $699 and $999, but inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice R4182-003 (Regional PPO) with no deductible and no coinsurance, featuring no copay for annual routine eye exams and eyewear (up to one pair of eyeglasses or contact lenses per year). Other eye exams have a copay up to $50, and there are annual limits of $75 for exams and $150 for eyewear; other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R4182-003 (Regional PPO) provides partially covered dental services, featuring no copay and no coinsurance for preventive care, and a $50 copay with no coinsurance for Medicare-covered dental services. While many diagnostic and comprehensive services are covered, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R4182-003 (Regional PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy are required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin drugs have a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice R4182-003 (Regional PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment is covered by HumanaChoice R4182-003 (Regional PPO), with durable medical equipment, prosthetics, and medical supplies requiring prior authorization and carrying a 20% coinsurance and no copay. Diabetic supplies from specified manufacturers feature a 10% to 20% coinsurance with no copay, while diabetic shoes and inserts require a $10 copay and coinsurance, with prior authorization required.
Diagnostic and Radiological Services See details
HumanaChoice R4182-003 (Regional PPO) covers diagnostic and radiological services, offering lab services with no copay and no coinsurance. Diagnostic procedures and tests range from a $0 to $100 copay with no coinsurance, while outpatient X-rays have no copay but require coinsurance. Therapeutic radiological services require a minimum $40 copay and 20% coinsurance, and diagnostic radiological services carry a minimum $0 copay.
Home Health Services See details
Home Health Services are covered by HumanaChoice R4182-003 (Regional PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under HumanaChoice R4182-003 (Regional PPO), although only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice R4182-003 (Regional PPO) covers Skilled Nursing Facility (SNF) services 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, a three-day prior hospital stay is not required, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
HumanaChoice R4182-003 (Regional PPO) partially covers other services, offering acupuncture for a $50 copay and no coinsurance up to 20 treatments per year, and a meal benefit for chronic illnesses with no copay and no coinsurance, both of which require prior authorization. Over-the-counter (OTC) items and other additional services are not covered under this plan.
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