Plan ID: H7284-006

What You Need to Know:

  • HumanaChoice Florida H7284-006 (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $75, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $3,900 per year (in-network).
  • HumanaChoice Florida H7284-006 (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $38.

$75

Monthly Premium

Medicare Plan Features
Monthly Premium: $75.00
Part C Premium: $36.70
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$75.00 $36.70 $38.30 $0 $38.30 $445.0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Defined Standard Benefit
Health Plan Type: Local PPO
Similar Plan: H7284-001
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $3,900
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Flagler, Florida: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members New plan - No summary rating as of yet. New plan - not yet rated. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,461 drugs
Number of Members Enrolled in this Plan in Flagler, Florida: NULL
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$36.70 $38.30 $0.00 $75.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$44.20 $30.60 $67.30 $22.90 $59.60 $15.20 $51.90
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
306 25% 599 25% 788 25% 1084 25% 684 25%

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Cigna Preferred Medicare (HMO) (2023)Local HMO$3,600$0
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Cigna Preferred Savings Medicare (HMO) (2023)Local HMO$5,050$0
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AARP Medicare Advantage Choice (PPO) (2023)Local PPO$5,900$175
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Humana Gold Choice H8145-061 (PFFS) (2023)PFFS$-$200
4
Humana Honor (HMO) (2023)Local HMO *$5,500$-
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AARP Medicare Advantage (HMO-POS) (2023)Local HMO$3,700$0
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4
HumanaChoice R5826-074 (Regional PPO) (2023)Regional PPO$7,550$395
4
AARP Medicare Advantage Patriot (Regional PPO) (2023)Regional PPO *$6,700$-
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WellCare Dividend Prime (HMO) (2023)Local HMO$3,200$0
4
WellCare Premier (PPO) (2023)Local PPO$4,500$150
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WellCare Elite (HMO) (2023)Local HMO$2,500$0
4
AdventHealth SunSaver Plan (HMO) (2023)Local HMO$5,500$0
4
FHCP Medicare Rx (HMO) (2023)Local HMO$6,700$295
4
BlueMedicare Choice (Regional PPO) (2023)Regional PPO$6,500$250
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
FHCP Medicare Rx Savings (HMO) (2023)Local HMO$7,550$395
4
HumanaChoice R5826-018 (Regional PPO) (2023)Regional PPO *$7,550$-
4
Medicare Advantage Plans by Humana
HumanaChoice Florida H5216-070 (PPO) (2023)Local PPO$5,500$175
4
Humana Gold Plus H1036-044 (HMO) (2023)Local HMO$3,400$0
4
Humana Gold Plus H1036-157 (HMO) (2023)Local HMO$5,500$0
4
Humana Gold Choice H8145-061 (PFFS) (2023)PFFS$-$200
4
Humana Honor (HMO) (2023)Local HMO *$5,500$-
4
HumanaChoice R5826-005 (Regional PPO) (2023)Regional PPO$6,700$100
4
HumanaChoice R5826-074 (Regional PPO) (2023)Regional PPO$7,550$395
4
HumanaChoice R5826-018 (Regional PPO) (2023)Regional PPO *$7,550$-
4

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