HumanaChoice H5216-083 (PPO) in Payne, Oklahoma (2023)
HumanaChoice H5216-083 (PPO) in Payne County, Oklahoma costs $76/mo. This affordable Regional PPO plan (H5216-083) is a top choice for those living in Payne County with a $195 prescription deductible and out-of-pocket limits at $6,700. Learn more about Medicare Part C by AARP in Payne County, Oklahoma below.
UPDATED: Sep 22, 2023
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4 out of 5 stars* for plan year 2024
Plan ID: H5216-083
What You Need to Know:
- HumanaChoice H5216-083 (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 $76, which does not include your monthly Medicare Part B premium.
- The annual deductible for this health plan is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
- The plan includes an out-of-pocket maximum of $6,700 per year (in-network).
- HumanaChoice H5216-083 (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
- This plan's Part D Initial Coverage Limit is $8.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$76
Monthly Premium
Medicare Plan Features | |||||||||
---|---|---|---|---|---|---|---|---|---|
Monthly Premium: | $76.00 | ||||||||
Part C Premium: | $54.60 | ||||||||
Monthly Premium: | Part C Premium: | Part D Drug Premium: | Part D Supplemental Premium: | Total Part D Premium: | Drug Deductible: | Tiers with No Deductible: | |||
$76.00 | $54.60 | $7.50 | $13.90 | $21.40 | $195.0 | 1.0 | |||
Gap Coverage: | No | ||||||||
Benchmark: | not below the regional benchmark | ||||||||
Type of Medicare Health: | Enhanced Alternative | ||||||||
Health Plan Type: | Local PPO | ||||||||
Similar Plan: | H5216-086 | ||||||||
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): | $6,700 | ||||||||
Annual Deductible: | $195 (Tier 1, 2 and 3 excluded from the Deductible.) | ||||||||
Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
Number of Members enrolled in this plan in Payne, Oklahoma: | 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: | Yes | ||||||||
Plan Health Benefits | |||||||||
Total # of Formulary Drugs: | 3,461 drugs | ||||||||
Number of Members Enrolled in this Plan in Payne, Oklahoma: | 475 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 | ||||||
$54.60 | $7.50 | $13.90 | $76.00 | ||||||
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 | |||
$68.50 | $19.50 | $74.10 | $17.60 | $72.20 | $15.80 | $70.40 | |||
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 | $8.00 | 599 | $15.00 | 788 | $47.00 | 1084 | $99.00 | 684 | 29% |
Other Medicare Advantage Plans in Payne, Oklahoma
Plan Name | Type | Premium MOOP | Rx Deduct. | Rating |
---|---|---|---|---|
HumanaChoice H9070-006 (PPO) (2023) | Local PPO | $5,900 | $0 | |
HumanaChoice R4845-001 (Regional PPO) (2023) | Regional PPO * | $3,400 | $- | |
HumanaChoice R4845-002 (Regional PPO) (2023) | Regional PPO | $6,700 | $395 | |
Lasso Healthcare Growth (MSA) (2023) | MSA * | $- | $- | |
Humana Honor (PPO) (2023) | Local PPO * | $4,500 | $- | |
Lasso Healthcare Growth Plus (MSA) (2023) | MSA * | $- | $- | |
HumanaChoice H5216-230 (PPO) (2023) | Local PPO | $4,900 | $0 | |
Humana Value Plus H9070-002 (PPO) (2023) | Local PPO | $7,550 | $350 | |
HumanaChoice H5216-081 (PPO) (2023) | Local PPO | $6,700 | $195 | |
Medicare Advantage Plans by Humana | ||||
HumanaChoice H9070-006 (PPO) (2023) | Local PPO | $5,900 | $0 | |
HumanaChoice R4845-001 (Regional PPO) (2023) | Regional PPO * | $3,400 | $- | |
HumanaChoice R4845-002 (Regional PPO) (2023) | Regional PPO | $6,700 | $395 | |
Humana Honor (PPO) (2023) | Local PPO * | $4,500 | $- | |
HumanaChoice H5216-230 (PPO) (2023) | Local PPO | $4,900 | $0 | |
Humana Value Plus H9070-002 (PPO) (2023) | Local PPO | $7,550 | $350 | |
HumanaChoice H5216-081 (PPO) (2023) | Local PPO | $6,700 | $195 |
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