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HumanaChoice R5826-018 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R5826-018 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R5826-018 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R5826-018 (Regional PPO) is a Regional PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in State of Florida. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice R5826-018 (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 R5826-018 (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 R5826-018 (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 has a $1300.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $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
Prescription drugs are not covered by HumanaChoice R5826-018 (Regional PPO).
Additional Benefits
The HumanaChoice R5826-018 (Regional PPO) offers comprehensive medical coverage featuring no copay for primary care visits, preventive services, and home health care. Specialist visits require a $30 copay, while emergency room visits have a $115 copay that is waived upon hospital admission. For inpatient hospital stays, members pay a daily copay of $275 for days 1 through 7 with no coinsurance. This plan also includes valuable supplemental benefits, such as dental care with a $1,000 annual limit and no copay for most preventive services. Routine vision and hearing exams are covered with no copay, alongside a $1,000 allowance for prescription hearing aids every three years. Additionally, the plan covers up to 25 acupuncture treatments per year with no copay, while durable medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
HumanaChoice R5826-018 (Regional PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $275 for days 1-7 of an acute stay and $195 for days 1-9 of a psychiatric stay, with no copay for subsequent covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice R5826-018 (Regional PPO) covers outpatient services with no coinsurance, including a $0 to $175 copay for outpatient hospital services, a $275 copay per stay for observation services, and no copay for ambulatory surgical center or blood services. Outpatient substance abuse services also feature no coinsurance and a $0 to $20 copay per session, with prior authorization required for most outpatient benefits.
Partial Hospitalization See details
HumanaChoice R5826-018 (Regional PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
HumanaChoice R5826-018 (Regional PPO) covers ground ambulance services with a copay of $120.00 to $240.00 and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
HumanaChoice R5826-018 (Regional PPO) covers emergency services 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 are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice R5826-018 (Regional PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Additional covered services include physical, occupational, and speech therapies ($15 to $35 copay), mental health services ($20 copay), and telehealth ($0 to $40 copay) with no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
HumanaChoice R5826-018 (Regional PPO) covers preventive services, including annual physical exams, kidney disease education, and screenings, with no copay and no coinsurance. Additional supplemental preventive benefits are only partially covered; a memory fitness benefit is included with no copay and no coinsurance, but services such as health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
HumanaChoice R5826-018 (Regional PPO) covers hearing services with a $30 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 limit every three years, though inner ear, outer ear, and over the ear types are not covered. OTC hearing aids are also covered with no copay and no coinsurance for up to two devices every three years.
Vision Services See details
Vision services are partially covered by HumanaChoice R5826-018 (Regional PPO) with no deductible and no coinsurance, offering routine eye exams, contact lenses, and eyeglasses with no copay. While there is a $0 to $30 copay for eye exams (up to $75 yearly) and a $100 yearly limit for eyewear, other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice R5826-018 (Regional PPO) partially covers dental services with a $1,000 annual maximum benefit for both in- and out-of-network care. Covered preventive and comprehensive services generally have no copay and no coinsurance, though Medicare-covered dental requires a $30 copay and no coinsurance, and removable prosthodontics require a 30% coinsurance and no copay. Fluoride treatments, endodontics, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R5826-018 (Regional PPO) covers Home Infusion bundled Services with no copay, although prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a 0% to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice R5826-018 (Regional PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice R5826-018 (Regional PPO), requiring a 20% coinsurance and no copayment for durable medical equipment, prosthetics, medical supplies, and diabetic supplies. Diabetic therapeutic shoes and inserts are covered with a $5 copayment, and prior authorization is required for most of these services.
Diagnostic and Radiological Services See details
HumanaChoice R5826-018 (Regional PPO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay. Outpatient diagnostic procedures and tests carry a copay of $0 to $100 with no coinsurance, while therapeutic radiological services require a minimum 20% coinsurance and a copay starting at $30.
Home Health Services See details
Home Health Services are covered by HumanaChoice R5826-018 (Regional PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice R5826-018 (Regional PPO) with no coinsurance, but in practice only some services are covered. Standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for PAD are not covered, with copayments for these services ranging from $15 to $30.
Skilled Nursing Facility (SNF) See details
HumanaChoice R5826-018 (Regional PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and requires no prior three-day inpatient hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $160 daily copay for days 21 through 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice R5826-018 (Regional PPO) partially covers other services, offering up to 25 acupuncture treatments per year with no copay and no coinsurance, subject to prior authorization. Other supplemental benefits, including over-the-counter items and meal benefits, are not covered.
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