A non-government entity
HumanaChoice R5826-074 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice R5826-074 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice R5826-074 (Regional PPO) in 2026, please refer to our full plan details page.
HumanaChoice R5826-074 (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 R5826-074 (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 R5826-074 (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 R5826-074 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.00. 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.
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 $10500.00 (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 $10500.00 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:
Sign up for HumanaChoice R5826-074 (Regional PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HumanaChoice R5826-074 (Regional PPO) Medicare prescription drug plan features an annual drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your medications before the plan's coverage begins. Understanding this initial cost is essential for estimating your overall healthcare budget and out-of-pocket expenses for the year. Specific drug tier details, including individual copayments and coinsurance rates for generic or brand-name medications, are not available for this plan. To determine how your specific prescriptions are covered and what your final costs will be, you will need to consult the plan's formulary directly.
Additional Benefits
The HumanaChoice R5826-074 (Regional PPO) plan offers robust coverage for essential medical needs with no copay or coinsurance for primary care doctor visits and annual physical exams. Specialist visits require a $50 copay, while inpatient hospital stays feature no coinsurance but require a copay of $625 per day for the first three days of acute care. Emergency room visits have a $115 copay, which is waived if you are admitted, and urgent care services are available for a $40 copay. This plan also provides routine hearing, vision, and preventive dental services with no copay or coinsurance, including up to $1,000 for hearing aids every three years. For specialized care, there is no copay or coinsurance for home health services and the first 20 days of skilled nursing facility stays, while medical equipment and dialysis require a 20% coinsurance. Additionally, diagnostic labs and outpatient X-rays are covered with no copay, helping keep your routine healthcare costs predictable.
Inpatient Hospital See details
HumanaChoice R5826-074 (Regional PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $625 copay for days 1 to 3 of acute stays and a $587 copay for days 1 to 3 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice R5826-074 (Regional PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services require a copay ranging from no copay up to $390 (or a $625 copay per stay for observation services), while outpatient substance abuse sessions require a $30 to $35 copay.
Partial Hospitalization See details
HumanaChoice R5826-074 (Regional PPO) covers partial hospitalization with a $35.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services under HumanaChoice R5826-074 (Regional PPO) include covered ground ambulance services with a $120.00 to $240.00 copay plus coinsurance, and air ambulance services with a 20% coinsurance plus a copay, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by HumanaChoice R5826-074 (Regional PPO) with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services have 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 R5826-074 (Regional PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $50 copay and no coinsurance. Physical, occupational, and speech therapy services are covered with a $10 to $35 copay and no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by HumanaChoice R5826-074 (Regional PPO), offering no copay and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and EKGs. However, additional services like health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, fitness benefits, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services covered by HumanaChoice R5826-074 (Regional PPO) feature no deductible, with routine hearing exams and fitting evaluations requiring no copay and no coinsurance, while Medicare-covered exams have a $50 copay and no coinsurance. OTC and prescription hearing aids are covered with no copay and no coinsurance up to a $1,000 limit every three years, although inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice R5826-074 (Regional PPO), which offers one routine eye exam and one pair of contacts or eyeglasses per year with no copay and no coinsurance. While these benefits are covered up to annual limits of $75 for exams and $100 for eyewear, other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice R5826-074 (Regional PPO), with Medicare-covered dental requiring a $50 copay and no coinsurance, while covered preventive and adjunctive services have no copay and no coinsurance. Fluoride, restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice R5826-074 (Regional PPO) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B chemotherapy and other drugs feature no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
HumanaChoice R5826-074 (Regional PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
HumanaChoice R5826-074 (Regional PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with a 20% coinsurance and no copay. Diabetic therapeutic shoes and inserts are also covered with a $5 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice R5826-074 (Regional PPO) with no copay for lab services and outpatient X-rays, and no coinsurance for diagnostic tests. Diagnostic procedures carry a copay of up to $290, while therapeutic radiological services require a minimum $50 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered by HumanaChoice R5826-074 (Regional PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the HumanaChoice R5826-074 (Regional PPO) plan with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice R5826-074 (Regional PPO) provides coverage for Skilled Nursing Facility (SNF) services with no coinsurance and no prior 3-day hospital stay required, though prior authorization is needed. The benefit is partially covered as there is no copay for days 1 to 20 and a $160 daily copay for days 21 to 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice R5826-074 (Regional PPO) provides partial coverage for other services, which includes acupuncture with no copay and no coinsurance for up to 25 treatments per year, subject to prior authorization. Other supplemental benefits, such as over-the-counter (OTC) items and meal benefits, are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved