3.5 out of 5 stars* for plan year 2024
$0.00 Monthly Premium
HumanaChoice H0473-004 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H0473-004-000
$0.00 Monthly Premium
Texas Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Texas Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
Coverage | Details |
---|---|
Monthly plan premium | $0.00 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $0.00 |
Out-of-pocket maximum | $7,200.00 |
Initial drug coverage limit | $0.00 |
Catastrophic drug coverage limit | $8,000.00 |
Primary care doctor visit | In-Network: Doctor Office Visit: |
Specialty doctor visit | In-Network: Doctor Specialty Visit: |
Inpatient hospital care | Out-of-Network: Coinsurance for Acute Hospital Services per Stay 50% |
Urgent care | Urgent Care: Copayment for Urgent Care $55.00 Worldwide Coverage: |
Emergency room visit | Emergency Care: 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: |
Ambulance transportation | Out-of-Network: Ambulance Services: |
Health Care Services and Medical Supplies
HumanaChoice H0473-004 (PPO) covers a range of additional benefits. Learn more about HumanaChoice H0473-004 (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage | Details |
---|---|
Chiropractic services | In-Network: Chiropractic Services: |
Diabetes supplies, training, nutrition therapy and monitoring | In-Network: Diabetic Supplies and Services: |
Durable medical equipment (DME) | Out-of-Network: Durable Medical Equipment: |
Diagnostic tests, lab and radiology services, and X-rays | In-Network: Outpatient Diag Procs/Tests/Lab Services: Outpatient Diag/Therapeutic Rad Services: |
Home health care | In-Network: Home Health Services: |
Mental health inpatient care | Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50% |
Mental health outpatient care | In-Network: Outpatient Mental Health Services: |
Outpatient services/surgery | In-Network: Outpatient Hospital Services: Outpatient Observation Services: Ambulatory Surgical Center Services: |
Outpatient substance abuse care | In-Network: Outpatient Substance Abuse Services: |
Over-the-counter items | In-Network: Over-The-Counter (OTC) Items: |
Podiatry services | Out-of-Network: Podiatry Services: |
Skilled Nursing Facility (SNF) care | In-Network: Skilled Nursing Facility Services: |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Dental care | In Network: $0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years.$0 copayment for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years.$0 copayment for bridge recementation, bridges-pontic, crown recementation, panoramic film or diagnostic x-rays up to 1 every 5 years.$0 copayment for bridges-crown up to 2 every 5 years.$0 copayment for crown, other restorative services - core buildup and prefabricated post and core, root canal, root canal retreatment up to 1 per tooth per lifetime.$0 copayment for bitewing x-rays, intraoral x-rays up to 1 set(s) per year.$0 copayment for emergency diagnostic exam up to 1 per year.$0 copayment for emergency treatment for pain, fluoride treatment, oral surgery, periodic oral exam, prophylaxis (cleaning) up to 2 per year.$0 copayment for periodontal maintenance up to 4 per year.$0 copayment for amalgam and/or composite filling, necessary anesthesia with covered service, simple or surgical extraction up to unlimited per year.$1,500 combined maximum benefit coverage amount per year for all preventive and comprehensive benefits. Out of Network: |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Vision benefits | In-Network: Eye Exams:
Prior Authorization Required for Eye Exams Eyewear:
Prior Authorization Required for Eyewear |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Hearing benefits | In-Network: Hearing Exams:
Prior Authorization Required for Hearing Exams Hearing Aids:
|
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening
Yearly "Wellness" visit |
When reviewing Texas Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Texas that offer similar benefits at similar or lower prices than the plan above. Call 1-855-298-6309 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
Links to plan documents |
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Texas Counties Served
Andrews Blanco Brooks Brown co*ke Concho Crosby Dawson De Witt Deaf Smith Dickens Duval Ector Garza Gillespie Goliad Gonzales Gray Hale Hall Hartley Haskell Hockley Howard Hudspeth Hutchinson Irion Jim Hogg Karnes Lamb Live Oak Lubbock Lynn Mcculloch Midland Moore Nolan Pecos Potter Randall Reeves Runnels San Saba Schleicher Starr Taylor Terry Uvalde Val Verde Ward Webb Zapata
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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