4

4 out of 5 stars* for plan year 2024

Plan ID: H5216-238

What You Need to Know:

  • HumanaChoice H5216-238 (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 .
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • HumanaChoice H5216-238 (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 $0.

* 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: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 $0 $0 $0 $0 $0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H5216-239
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): $7,550
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Hampton, South Carolina: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
122 members 4 out of 5 Stars. 4 out of 5 Stars. 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 Hampton, South Carolina: 9,709 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
$0.00 $0.00 $0.00 $0.00
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
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
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 $4.00 599 $12.00 788 $47.00 1084 $100.00 684 33%

Other Medicare Advantage Plans in Hampton, South Carolina

Plan Name Type Premium MOOP Rx Deduct. Rating
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New plan - not yet rated.
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5
Aetna Medicare Elite Plan (PPO) (2023)Local PPO$7,500$0
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Clear Spring Health Choice Plan (PPO) (2023)Local PPO$7,550$200
Insufficient data to rate this plan.
AARP Medicare Advantage Plan 1 (HMO-POS) (2023)Local HMO$5,900$0
5
Clear Spring Health Gold Plus (PPO) (2023)Local PPO$6,700$200
Insufficient data to rate this plan.
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
WellCare Flex Complete (PPO) (2023)Local PPO$2,500$0
4
Clear Spring Health Select Plan (HMO) (2023)Local HMO$7,550$0
Insufficient data to rate this plan.
Allwell Medicare (HMO) (2023)Local HMO$7,550$0
5
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage Plan 2 (HMO-POS) (2023)Local HMO$4,500$0
5
UnitedHealthcare Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5
AARP Medicare Advantage Patriot (HMO-POS) (2023)Local HMO *$4,500$-
5
HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
4
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4
WellCare Elite (HMO) (2023)Local HMO$3,400$0
5
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
WellCare Plus (HMO) (2023)Local HMO$3,000$445
5
WellCare Compass (HMO) (2023)Local HMO$3,450$445
5
Humana Gold Plus H5619-132 (HMO) (2023)Local HMO$7,550$0
4
WellCare Premier (PPO) (2023)Local PPO$5,500$100
4
WellCare Patriot (HMO-POS) (2023)Local HMO *$3,450$-
5
UnitedHealthcare Medicare Advantage Patriot (Regional PPO (2023)Regional PPO *$6,700$-
5
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
Clover Health Choice (PPO) (2023)Local PPO$7,550$0
4
Clover Health Choice Value (PPO) (2023)Local PPO$7,550$0
4
WellCare Prime (PPO) (2023)Local PPO$6,000$0
4
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
WellCare Absolute (PPO) (2023)Local PPO$6,700$90
4
Medicare Advantage Plans by Humana
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
4
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4
Humana Gold Plus H5619-132 (HMO) (2023)Local HMO$7,550$0
4
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4

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