4

4 out of 5 stars* for plan year 2024

Plan ID: H5216-105

What You Need to Know:

  • HumanaChoice H5216-105 (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 $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is no drug coverage.
  • The plan includes an out-of-pocket maximum of $4,500 per year (in-network).
  • HumanaChoice H5216-105 (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is no drug coverage.
  • This plan's Part D Initial Coverage Limit is .

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: NULL
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local PPO *
Similar Plan: H5216-106
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $4,500
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in McCreary, Kentucky: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members 4 out of 5 Stars. 4 out of 5 Stars. 4 out of 5 Stars.
Plan Offers Mail Order: NULL
Plan Health Benefits
Total # of Formulary Drugs: NULL
Number of Members Enrolled in this Plan in McCreary, Kentucky: 1,701 members
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
NULL NULL NULL NULL
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
NULL NULL NULL NULL NULL NULL NULL
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)
NULL NULL NULL NULL NULL NULL NULL NULL NULL NULL

Other Medicare Advantage Plans in McCreary, Kentucky

Plan Name Type Premium MOOP Rx Deduct. Rating
Humana Value Plus H5525-040 (PPO) (2023)Local PPO$7,550$260
4
WellCare Dividend (HMO) (2023)Local HMO$6,700$0
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WellCare Premier (PPO) (2023)Local PPO$5,500$100
New plan - not yet rated.
WellCare Elite (HMO) (2023)Local HMO$5,000$0
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Anthem MediBlue Plus (HMO) (2023)Local HMO$5,300$0
5
WellCare Compass (HMO) (2023)Local HMO$5,000$445
5
Anthem MediBlue Access Basic (Regional PPO) (2023)Regional PPO$6,400$100
5
Anthem MediBlue Access (PPO) (2023)Local PPO$5,900$0
4
Anthem MediBlue Access Plus (PPO) (2023)Local PPO$6,400$125
4
Anthem MediBlue Access Core (PPO) (2023)Local PPO *$4,900$-
4
HumanaChoice H5216-226 (PPO) (2023)Local PPO$6,700$195
4
WellCare Patriot (HMO-POS) (2023)Local HMO *$5,000$-
5
HumanaChoice H5525-044 (PPO) (2023)Local PPO$6,700$0
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
HumanaChoice R0865-001 (Regional PPO) (2023)Regional PPO *$6,200$-
4
HumanaChoice R0865-003 (Regional PPO) (2023)Regional PPO$6,700$195
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Medicare Advantage Plans by Humana
Humana Value Plus H5525-040 (PPO) (2023)Local PPO$7,550$260
4
HumanaChoice H5216-226 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice H5525-044 (PPO) (2023)Local PPO$6,700$0
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
HumanaChoice R0865-001 (Regional PPO) (2023)Regional PPO *$6,200$-
4
HumanaChoice R0865-003 (Regional PPO) (2023)Regional PPO$6,700$195
4

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