4

4 out of 5 stars* for plan year 2024

Plan ID: H5216-239

What You Need to Know:

  • Humana Care Extra (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).
  • Humana Care Extra (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: H5216-241
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 Cobb, Georgia: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
41 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 Cobb, Georgia: 117 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 Cobb, Georgia

Plan Name Type Premium MOOP Rx Deduct. Rating
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
UnitedHealthcare Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$6,700$150
4
Anthem MediBlue Core (HMO) (2023)Local HMO *$7,550$-
5
HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
4
Cigna True Choice Medicare (PPO) (2023)Local PPO$7,400$195
New plan - not yet rated.
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
UnitedHealthcare Medicare Advantage Patriot (Regional PPO (2023)Regional PPO *$6,700$-
5
Anthem MediBlue Plus (HMO) (2023)Local HMO$6,700$150
5
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
CareSource Advantage (HMO) (2023)Local HMO$4,600$30
New plan - not yet rated.
Allwell Medicare (HMO) (2023)Local HMO$7,550$280
5
CareSource Advantage Zero Premium (HMO) (2023)Local HMO$6,700$100
New plan - not yet rated.
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
Anthem MediBlue Access (PPO) (2023)Local PPO$5,900$95
4
Anthem MediBlue Extra (HMO) (2023)Local HMO$5,900$445
5
HumanaChoice H5216-203 (PPO) (2023)Local PPO$7,550$0
4
Cigna Preferred Medicare (HMO) (2023)Local HMO$7,200$95
4
Kaiser Permanente Senior Advantage Basic (HMO) (2023)Local HMO$6,400$0
5
Aetna Medicare Advantra Preferred Plan (PPO) (2023)Local PPO$7,550$200
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Sonder Health Plans, Inc (HMO) (2023)Local HMO$5,900$0
New plan - not yet rated.
AARP Medicare Advantage Walgreens (HMO) (2023)Local HMO$6,700$275
5
LiveHealthy: Clover Powered, Walmart Enhanced (PPO) (2023)Local PPO$7,550$0
4
Aetna Medicare Freedom Plan (PPO) (2023)Local PPO$7,000$200
New plan - not yet rated.
WellCare Patriot (HMO-POS) (2023)Local HMO *$3,400$-
5
LiveHealthy LI: Clover Powered, Walmart Enhanced (PPO) (2023)Local PPO$7,550$445
4
Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$6,900$-
New plan - not yet rated.
HumanaChoice H5216-071 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice H5216-073 (PPO) (2023)Local PPO$6,700$360
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
WellCare Dividend (HMO) (2023)Local HMO$6,700$200
5
Humana Gold Plus H4141-017 (HMO) (2023)Local HMO$7,550$0
4
WellCare Endurance (PPO) (2023)Local PPO$4,900$0
5
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4
WellCare Premier (PPO) (2023)Local PPO$4,900$75
5
WellCare Prime (PPO) (2023)Local PPO$5,100$0
5
WellCare Choice (HMO) (2023)Local HMO$6,700$0
5
WellCare Compass (HMO) (2023)Local HMO$3,450$445
5
Cigna Preferred GA Medicare (HMO) (2023)Local HMO$7,500$300
4
Kaiser Permanente Senior Advantage Enhanced (HMO) (2023)Local HMO$4,500$0
5
WellCare Flex Complete (PPO) (2023)Local PPO$2,500$0
5
Medicare Advantage Plans by Humana
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
4
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
HumanaChoice H5216-203 (PPO) (2023)Local PPO$7,550$0
4
HumanaChoice H5216-071 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice H5216-073 (PPO) (2023)Local PPO$6,700$360
4
Humana Gold Plus H4141-017 (HMO) (2023)Local HMO$7,550$0
4
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4

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