Humana Honor (PPO) - 2021

H5216-235-000 - Humana - Local PPO *

Humana Honor (PPO) is a Medicare Advantage plan provided by Humana. This plan does not provide drug coverage.

In terms of networks, this plan is a Local PPO. With a PPO, you don’t need to choose a primary care doctor and can utilize healthcare providers inside or outside your network (although you'll typically pay less for providers in a plan's network). Local PPOs cover only a small service area, such as a part of a county, a single county, or a group of counties. If you need a wider area of coverage, you may want to look at Regional PPO plans if any are available in your region.

More details on this plan are provided below. If you have questions, don’t hesitate to use our site to reach out to a licensed Medicare agent for help today. Alternatively, if you know what plan you want, you can enroll online yourself using our site as well.


Plan Basics
Contract Year 2021
Medicare Type Medicare Advantage Plan (Part C)
CMS Plan ID H5216-235-000
Plan Organization Humana
Plan Type Local PPO *
Plan Name Humana Honor (PPO)
Drugs Covered No
Doctors Choice Any Doctor
Overall Star Rating 4
Plan Cost Sharing
Premium $0.00
Total Premium (Includes Part B) $105.50
Monthly Part C Premium $0.00
Maximum Out-of-Pocket Limit for Parts A & B (MOOP) $3400.00

Medicare Advantage Plan Health Benefits


Additional Benefits And/or Reduced Cost-sharing For Enrollees With Certain Health Conditions?
Service Cap Network Auth. Req. Ref. Req. Cost Share
- In-Network - - No
Comprehensive Dental
Service Cap Network Auth. Req. Ref. Req. Cost Share
Diagnostic services No - - - Not covered
Endodontics Yes Out-of-Network Yes No $0 copay
Extractions Yes Out-of-Network Yes No $0 copay
Non-routine services Yes Out-of-Network Yes No $0 copay
Periodontics Yes Out-of-Network Yes No $0 copay
Prosthodontics, other oral/maxillofacial surgery, other services Yes Out-of-Network Yes No $0 copay
Restorative services Yes Out-of-Network Yes No $0 copay
Diagnostic Procedures/lab Services/imaging
Service Cap Network Auth. Req. Ref. Req. Cost Share
Diagnostic radiology services (e.g., MRI) - Out-of-Network Yes No 30% coinsurance
Diagnostic tests and procedures - Out-of-Network Yes No $0 copay or 30% coinsurance
Lab services - Out-of-Network Yes No 30% coinsurance
Outpatient x-rays - Out-of-Network Yes No 30% coinsurance
Doctor Visits
Service Cap Network Auth. Req. Ref. Req. Cost Share
Primary - Out-of-Network - - 30% coinsurance per visit
Specialist - Out-of-Network No No 30% coinsurance per visit
Emergency Care/Urgent Care
Service Cap Network Auth. Req. Ref. Req. Cost Share
Emergency - - - - $90 copay per visit (always covered)
Urgent care - - - - $10-30 copay or 30% coinsurance per visit (always covered)
Foot Care (podiatry Services)
Service Cap Network Auth. Req. Ref. Req. Cost Share
Foot exams and treatment - Out-of-Network Yes No 30% coinsurance
Routine foot care - - - - Not covered
Ground Ambulance
Service Cap Network Auth. Req. Ref. Req. Cost Share
- Out-of-Network - - $290 copay
Health Plan Deductible
Service Cap Network Auth. Req. Ref. Req. Cost Share
- - - - $250 annual deductible
Hearing
Service Cap Network Auth. Req. Ref. Req. Cost Share
Fitting/evaluation Yes Out-of-Network Yes No $0 copay
Hearing aids Yes Out-of-Network No No $399-699 copay
Hearing exam - Out-of-Network Yes No 30% coinsurance
Inpatient Hospital Coverage
Service Cap Network Auth. Req. Ref. Req. Cost Share
- Out-of-Network Yes No 30% per stay
Maximum Out-of-pocket Enrollee Responsibility (does Not Include Prescription Drugs)
Service Cap Network Auth. Req. Ref. Req. Cost Share
- - - - $5,100 In and Out-of-network$3,400 In-network
Medical Equipment/supplies
Service Cap Network Auth. Req. Ref. Req. Cost Share
Diabetes supplies - Out-of-Network Yes - 30% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) - Out-of-Network Yes - 20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs) - Out-of-Network Yes - 30% coinsurance per item
Medicare Part B Drugs
Service Cap Network Auth. Req. Ref. Req. Cost Share
Chemotherapy - Out-of-Network Yes - 20-30% coinsurance
Other Part B drugs - Out-of-Network Yes - 20-30% coinsurance
Mental Health Services
Service Cap Network Auth. Req. Ref. Req. Cost Share
Inpatient hospital - psychiatric - Out-of-Network Yes No 30% per stay
Outpatient group therapy visit - Out-of-Network Yes No 30% coinsurance
Outpatient group therapy visit with a psychiatrist - Out-of-Network Yes No 30% coinsurance
Outpatient individual therapy visit - Out-of-Network Yes No 30% coinsurance
Outpatient individual therapy visit with a psychiatrist - Out-of-Network Yes No 30% coinsurance
Optional Supplemental Benefits
Service Cap Network Auth. Req. Ref. Req. Cost Share
- - - - No
Other Health Plan Deductibles?
Service Cap Network Auth. Req. Ref. Req. Cost Share
- In-Network - - No
Outpatient Hospital Coverage
Service Cap Network Auth. Req. Ref. Req. Cost Share
- Out-of-Network Yes No 30% coinsurance per visit
Preventive Care
Service Cap Network Auth. Req. Ref. Req. Cost Share
- Out-of-Network No No $0 copay or 30% coinsurance
Preventive Dental
Service Cap Network Auth. Req. Ref. Req. Cost Share
Cleaning Yes Out-of-Network No No $0 copay
Dental x-ray(s) Yes Out-of-Network No No $0 copay
Fluoride treatment Yes Out-of-Network No No $0 copay
Oral exam Yes Out-of-Network No No $0 copay
Rehabilitation Services
Service Cap Network Auth. Req. Ref. Req. Cost Share
Occupational therapy visit - Out-of-Network Yes No 30% coinsurance
Physical therapy and speech and language therapy visit - Out-of-Network Yes No 30% coinsurance
Skilled Nursing Facility
Service Cap Network Auth. Req. Ref. Req. Cost Share
- Out-of-Network Yes No 30% per stay
Transportation
Service Cap Network Auth. Req. Ref. Req. Cost Share
- - - - Not covered
Vision
Service Cap Network Auth. Req. Ref. Req. Cost Share
Contact lenses Yes Out-of-Network Yes No $0 copay
Eyeglass frames No - - - Not covered
Eyeglass lenses No - - - Not covered
Eyeglasses (frames and lenses) Yes Out-of-Network Yes No $0 copay
Other No - - - Not covered
Routine eye exam Yes Out-of-Network Yes No $0 copay
Upgrades - - - - Not covered
Wellness Programs (e.g., Fitness, Nursing Hotline)
Service Cap Network Auth. Req. Ref. Req. Cost Share
- - No No Covered
Official Medicare Contact
Medicare Phone 1-800-MEDICARE (1-800-633-4227)
Medicare TTY User 1-877-486-2048
Plan Available in these Counties
Anderson County, Tennessee, Bedford County, Tennessee, Benton County, Tennessee, Bledsoe County, Tennessee, Blount County, Tennessee, Bradley County, Tennessee, Campbell County, Tennessee, Cannon County, Tennessee, Carroll County, Tennessee, Carter County, Tennessee, Cheatham County, Tennessee, Chester County, Tennessee, Claiborne County, Tennessee, Clay County, Tennessee, Cocke County, Tennessee, Coffee County, Tennessee, Crockett County, Tennessee, Cumberland County, Tennessee, Davidson County, Tennessee, Decatur County, Tennessee, Dekalb County, Tennessee, Dickson County, Tennessee, Dyer County, Tennessee, Fayette County, Tennessee, Fentress County, Tennessee, Franklin County, Tennessee, Gibson County, Tennessee, Giles County, Tennessee, Grainger County, Tennessee, Greene County, Tennessee, Grundy County, Tennessee, Hamblen County, Tennessee, Hamilton County, Tennessee, Hancock County, Tennessee, Hardeman County, Tennessee, Hardin County, Tennessee, Hawkins County, Tennessee, Haywood County, Tennessee, Henderson County, Tennessee, Henry County, Tennessee, Hickman County, Tennessee, Houston County, Tennessee, Humphreys County, Tennessee, Jackson County, Tennessee, Jefferson County, Tennessee, Johnson County, Tennessee, Knox County, Tennessee, Lake County, Tennessee, Lauderdale County, Tennessee, Lawrence County, Tennessee, Lewis County, Tennessee, Lincoln County, Tennessee, Loudon County, Tennessee, Macon County, Tennessee, Madison County, Tennessee, Marion County, Tennessee, Marshall County, Tennessee, Maury County, Tennessee, Mcminn County, Tennessee, Mcnairy County, Tennessee, Meigs County, Tennessee, Monroe County, Tennessee, Montgomery County, Tennessee, Moore County, Tennessee, Morgan County, Tennessee, Obion County, Tennessee, Overton County, Tennessee, Perry County, Tennessee, Pickett County, Tennessee, Polk County, Tennessee, Putnam County, Tennessee, Rhea County, Tennessee, Roane County, Tennessee, Robertson County, Tennessee, Rutherford County, Tennessee, Scott County, Tennessee, Sequatchie County, Tennessee, Sevier County, Tennessee, Shelby County, Tennessee, Smith County, Tennessee, Stewart County, Tennessee, Sullivan County, Tennessee, Sumner County, Tennessee, Tipton County, Tennessee, Trousdale County, Tennessee, Unicoi County, Tennessee, Union County, Tennessee, Van Buren County, Tennessee, Warren County, Tennessee, Washington County, Tennessee, Wayne County, Tennessee, Weakley County, Tennessee, White County, Tennessee, Williamson County, Tennessee, Wilson County, Tennessee

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