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Humana USAA Honor (PPO)

Humana Inc.
Humana USAA Honor (PPO) H5216-329 Plan Details
4.5 out of 5 stars

Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H5216-329

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H5216-329

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Humana Inc.
Humana USAA Honor (PPO) H5216-329 Plan Details
4.5 out of 5 stars

Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H5216-329

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Arkansas Counties Served

Crawford Jefferson Van Buren Conway Saline Montgomery Faulkner Sevier Saint Francis Poinsett Benton Logan Bradley Cross Independence Lee Boone Hot Spring Ouachita Jackson Prairie Searcy Clay Perry Washington Nevada Mississippi Franklin Scott Greene Mccurtain Pike Lawrence Crittenden Cleburne Cleveland Sebastian Polk Madison Fulton Calhoun Johnson Garland Dallas Little River Stone Ashley Union Carroll Miller Arkansas Lafayette Le Flore Lonoke Craighead Yell Pulaski Drew Clark Hempstead Randolph Desha Izard Sharp Chicot Phillips Howard Columbia Grant Baxter Pope Newton

Illinois Counties Served

Bond Macoupin Monroe Clinton Jersey Madison Calhoun Saint Clair

Iowa Counties Served

Dickinson Shelby Clinton Obrien Clay Davis Greene Decatur Wapello Hardin Allamakee Keokuk Iowa Appanoose Scott Adams Plymouth Page Humboldt Cerro Gordo Warren Union Buchanan Grundy Jefferson Howard Pocahontas Washington Worth Cherokee Linn Bremer Lyon Pottawattamie Marion Jones Dallas Winneshiek Madison Henry Cass Polk Chickasaw Tama Des Moines Winnebago Story Osceola Fayette Mahaska Crawford Burt Monona Ringgold Dubuque Audubon Lee Calhoun Montgomery Guthrie Emmet Floyd Black Hawk Kossuth Lucas Poweshiek Wright Marshall Hamilton Clayton Hancock Clarke Palo Alto Fremont Woodbury Sioux Van Buren Sac Franklin Mills Carroll Butler Wayne Mitchell Delaware Muscatine Ida Boone Cedar Benton Jackson Monroe Webster Johnson Adair Jasper Harrison Louisa

Kansas Counties Served

Thayer Osage Crawford Bourbon Sedgwick Washington Sumner Ellsworth Atchison Nemaha Franklin Marion Allen Geary Clay Neosho Leavenworth Reno Ottawa Jefferson Miami Montgomery Russell Butler Brown Barton Marshall Chase Wabaunsee Kingman Rice Linn Labette Doniphan Cherokee Johnson Douglas Wyandotte Pratt Coffey Harper Lyon Harvey Dickinson Pottawatomie Wilson Greenwood Anderson Riley Morris Shawnee Pawnee Jackson Mcpherson Cowley

Missouri Counties Served

Miller Wright Lincoln Mississippi Carroll New Madrid Sullivan Osage Carter Howard Pulaski Howell Grundy Saint Louis City Benton Bollinger Caldwell Cedar Iron Polk Dunklin Reynolds Cooper Washington Platte Clay Cass Mcdonald Andrew Nodaway Saint Clair Atchison Randolph Gasconade Camden Saint Charles Worth Dekalb Jackson Johnson Montgomery Adair Jasper Clinton Shannon Butler Laclede Crawford Lawrence Webster Monroe Pettis Texas Daviess Dent Chariton Lafayette Holt Pike Pemiscot Knox Franklin Macon Marion Shelby Linn Vernon Ozark Maries Bates Jefferson Dade Stone Stoddard Perry Ralls Gentry Putnam Sainte Genevieve Warren Douglas Taney Christian Audrain Saint Francois Ripley Ray Lewis Scotland Mercer Oregon Barry Boone Dallas Hickory Saint Louis Cole Newton Clark Moniteau Madison Greene Callaway Phelps Schuyler Morgan Saline Wayne Barton Henry

Nebraska Counties Served

Cheyenne Nemaha Douglas Madison Gage Sioux Rawlins Dixon Seward Saunders Decatur Thurston Jefferson Kimball Otoe Colfax Thayer Republic Banner York Fillmore Cass Dakota Polk Weld Saline Lancaster Burt Washington Wayne Gregory Platte Nance Butler

Oklahoma Counties Served

Jackson Hughes Kay Mayes Osage Ottawa Le Flore Greer Wagoner Pittsburg Haskell Dewey Grady Canadian Pontotoc Okfuskee Grant Noble Muskogee Pottawatomie Major Blaine Cherokee Adair Oklahoma Comanche Cotton Pawnee Mcclain Woodward Alfalfa Tillman Carter Craig Seminole Pushmataha Delaware Marshall Bryan Latimer Payne Jefferson Garvin Lincoln Mccurtain Creek Stephens Sequoyah Tulsa Love Atoka Murray Logan Caddo Cleveland Kiowa Sebastian Choctaw Garfield Okmulgee Woods Johnston Kingfisher Nowata Mcintosh

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $-1
Out of Pocket Max In-Network: $6700
Out-of-Network: N/A
Initial Coverage Limit $5030
Catastrophic Coverage Limit $8,000
Primary Care Doctor Visit
In-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0.00
Out-of-Network:

Doctor Office Visit:
Coinsurance for Medicare Covered Primary Care Office Visit 40%
Specialty Doctor Visit
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $40.00
Out-of-Network:

Doctor Specialty Visit:
Coinsurance for Medicare Covered Physician Specialist Office Visit 40%
Inpatient Hospital Care
In-Network:

Acute Hospital Services:
$425.00 per day for days 1 to 5
$0.00 per day for days 6 to 90
Prior Authorization Required for Acute Hospital Services
Prior authorization required
Out-of-Network:
Coinsurance for Acute Hospital Services per Stay 40%
Urgent Care
Copayment for Urgent Care $55.00

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $100.00
Emergency Room Visit
Copayment for Emergency Care $100.00
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $100.00
Copayment for Worldwide Emergency Transportation $100.00
Ambulance Transportation
In-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $265.00

Air Ambulance:
Copayment for Air Ambulance Services $265.00

Please see Evidence of Coverage for Prior Authorization rules
Prior authorization required
Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $265.00
Copayment for Medicare Covered Ambulance Services - Air $265.00

Health Care Services and Medical Supplies

Humana USAA Honor (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network:
Copayment for Medicare-covered Chiropractic Services $15.00
Prior Authorization Required for Chiropractic Services
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Chiropractic Services 40%
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network:
Copayment for Medicare-covered Diabetic Supplies $0.00
Coinsurance for Medicare-covered Diabetic Supplies 10%
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $0.00
Prior Authorization Required for Diabetic Supplies and Services
Diabetic Supplies and Services limited to those from specified manufacturers(Please see Evidence of Coverage)
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Diabetic Supplies and Services 40%
Durable Medical Eqipment (DME)
In-Network:
Coinsurance for Medicare-covered Durable Medical Equipment 15%
Prior Authorization Required for Durable Medical Equipment
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Durable Medical Equipment 15%
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $0.00 to $55.00
Coinsurance for Medicare-covered Diagnostic Procedures/Tests 25%
Copayment for Medicare-covered Lab Services $0.00 to $35.00
Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $275.00
Copayment for Medicare-covered Therapeutic Radiological Services $35.00 to $40.00
Copayment for Medicare-covered X-Ray Services $0.00 to $55.00
Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services
Prior authorization required
Out-of-Network:

Outpatient Diag Procs/Tests/Lab Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests 40%
Coinsurance for Medicare Covered Lab Services 40%
Coinsurance for Medicare Covered Diagnostic Radiological Services 40%
Coinsurance for Medicare Covered Therapeutic Radiological Services 40%
Coinsurance for Medicare Covered Outpatient X-Ray Services 40%
Home Health Care
In-Network:
Copayment for Medicare-covered Home Health Services $0.00
Prior Authorization Required for Home Health Services
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Home Health 40%
Mental Health Inpatient Care
In-Network:

Psychiatric Hospital Services:
$370.00 per day for days 1 to 5
$0.00 per day for days 6 to 90
Prior Authorization Required for Psychiatric Hospital Services
Prior authorization required
Out-of-Network:
Coinsurance for Psychiatric Hospital Services per Stay 40%
Mental Health Outpatient Care
In-Network:
Copayment for Medicare-covered Individual Sessions $40.00
Copayment for Medicare-covered Group Sessions $40.00
Prior Authorization Required for Outpatient Mental Health Services
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Individual Sessions 40%
Coinsurance for Medicare Covered Group Sessions 40%
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0.00 to $325.00
Prior Authorization Required for Outpatient Hospital Services

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $425.00
Prior Authorization Required for Outpatient Observation Services

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0.00 to $275.00
Prior Authorization Required for Ambulatory Surgical Center Services
Prior authorization required
Out-of-Network:

Outpatient Hospital and ASC Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%
Outpatient Substance Abuse Care
In-Network:
Copayment for Medicare-covered Individual Sessions $35.00
Copayment for Medicare-covered Group Sessions $35.00
Prior Authorization Required for Outpatient Substance Abuse Services
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Individual or Group Sessions 40%
Over-the-counter (OTC) Items
In-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0.00
Maximum Plan Benefit of $50.00 every three months
Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit
Out-of-Network:

Over-The-Counter (OTC) Items:
Coinsurance for Non-Medicare Covered Over-The-Counter (OTC) Items 50%
Maximum Plan Benefit of $50.00
Podiatry Services
In-Network:
Copayment for Medicare-Covered Podiatry Services $40.00
Prior Authorization Required for Podiatry Services
Prior authorization required
Out-of-Network:
Coinsurance for Medicare Covered Podiatry Services 40%
Skilled Nursing Facility Care
In-Network:

Skilled Nursing Facility Services:
$0.00 per day for days 1 to 20
$203.00 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services
Prior authorization required
Out-of-Network:
Coinsurance for Skilled Nursing Facility Services per Stay 40%

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
In Network:
Plan covers up to $1,000 allowance every year for non-Medicare covered preventive and comprehensive dental services. You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire. Your benefit can be used for most dental treatments such as: Preventive dental services, such as exams, routine cleanings, etc. Basic dental services, such as fillings, extractions, etc. Major dental services, such as periodontal scaling, crowns, dentures, root canals, bridges etc. Note: The allowance cannot be used on cosmetic services and implants.

Out of Network:
Plan covers up to $1,000 allowance every year for non-Medicare covered preventive and comprehensive dental services. You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire. Your benefit can be used for most dental treatments such as: Preventive dental services, such as exams, routine cleanings, etc. Basic dental services, such as fillings, extractions, etc. Major dental services, such as periodontal scaling, crowns, dentures, root canals, bridges etc. Note: The allowance cannot be used on cosmetic services and implants. Benefits received out-of-network are subject to any in-network benefit maximums, limitations, and/or exclusions.

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In-Network:

Eye Exams:
Copayment for Medicare Covered Benefits $0.00 to $40.00
Copayment for Routine Eye Exams $0.00
  • Maximum 1 Routine Eye Exam every year
Maximum Plan Benefit of $75.00 every year for in and out of network services combined
Prior Authorization Required for Eye Exams

Eyewear:
Copayment for Medicare-Covered Benefits $0.00
Copayment for Contact Lenses $0.00
  • Maximum 1 Pair every year
Copayment for Eyeglasses (lenses and frames) $0.00
  • Maximum 1 Pair every year
Maximum Plan Benefit of $150.00 every year for all Non-Medicare covered eyewear for in and out of network services combined
Prior Authorization Required for Eyewear
Prior authorization required
Out-of-Network:

Medicare Covered Vision Services:
Coinsurance for Medicare Covered Eye Exams 40%
Copayment for Medicare Covered Eyewear $0.00
Non-Medicare Covered Vision Services:
Copayment for Non-Medicare Covered Eye Exams $0.00
Copayment for Non-Medicare Covered Eyewear $0.00

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $40.00
Copayment for Routine Hearing Exams $0.00
  • Maximum 1 visit every year
Copayment for Fitting/Evaluation for Hearing Aid $0.00
Prior Authorization Required for Hearing Exams

Hearing Aids:
Copayment for Hearing Aids $399.00 to $699.00
  • Maximum 2 Hearing Aids every year
$399 copayment per ear per year for advanced level hearing aid purchase or $699 copayment per ear per year for premium level hearing aid purchase.
Prior authorization required
Out-of-Network:

Medicare Covered Hearing Services:
Coinsurance for Medicare Covered Hearing Exams 40%
Non-Medicare Covered Hearing Services:
Coinsurance for Non-Medicare Covered Hearing Exams 50%
Coinsurance for Non-Medicare Covered Hearing Aids 50%

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
    • Tobacco use cessation
    Yearly "Wellness" visit
    Out-of-Network:

    Medicare-covered Zero Dollar Preventive Services:
    Copayment for Medicare Covered Medicare-covered Preventive Services $0.00
    Coinsurance for Medicare Covered Medicare-covered Preventive Services 40%
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