4

4 out of 5 stars* for plan year 2024

Plan ID: H5216-064

What You Need to Know:

  • HumanaChoice H5216-064 (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 $45, 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 $6,700 per year (in-network).
  • HumanaChoice H5216-064 (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 $39.

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$45

Monthly Premium

Medicare Plan Features
Monthly Premium: $45.00
Part C Premium: $6.20
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$45.00 $6.20 $38.80 $0 $38.80 $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: H5216-065
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: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in East Baton Rouge, Louisiana: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
155 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 East Baton Rouge, Louisiana: 7,643 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
$6.20 $38.80 $0.00 $45.00
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
$10.70 $30.20 $36.40 $21.70 $27.90 $13.10 $19.30
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 $5.00 599 $15.00 788 $47.00 1084 $99.00 684 33%

Other Medicare Advantage Plans in East Baton Rouge, Louisiana

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Wellcare Absolute (PPO) (2023)Local PPO$7,550$195
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HumanaChoice R0110-003 (Regional PPO) (2023)Regional PPO$7,550$400
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Allwell Medicare (HMO) (2023)Local HMO$7,550$0
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HumanaChoice R0110-001 (Regional PPO) (2023)Regional PPO *$7,550$-
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
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Vantage BASIC (HMO-POS) (2023)Local HMO$5,900$445
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Aetna Medicare Value Plus Plan (PPO) (2023)Local PPO$7,550$195
5
Humana-Ochsner Network H1951-039 (HMO) (2023)Local HMO$3,700$0
4
Humana Gold Plus H1951-048 (HMO) (2023)Local HMO$3,700$0
4
Peoples Health Choices 65 (HMO) (2023)Local HMO$4,700$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
WellCare Value (HMO) (2023)Local HMO$3,400$0
5
Peoples Health Patriot (PPO) (2023)Local PPO *$6,700$-
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Peoples Health Choices (PPO) (2023)Local PPO$6,700$100
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WellCare Compass (HMO) (2023)Local HMO$3,400$445
5
Blue Advantage (PPO) (2023)Local PPO$3,500$0
5
Allwell Medicare Simple (HMO) (2023)Local HMO *$5,500$-
New plan - not yet rated.
WellCare Baton Rouge Preferred (HMO) (2023)Local HMO$3,400$0
5
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
WellCare Endurance (HMO) (2023)Local HMO$3,400$0
5
Medicare Advantage Plans by Humana
HumanaChoice H5216-202 (PPO) (2023)Local PPO$6,700$400
4
HumanaChoice R0110-003 (Regional PPO) (2023)Regional PPO$7,550$400
4
HumanaChoice R0110-001 (Regional PPO) (2023)Regional PPO *$7,550$-
4
Humana-Ochsner Network H1951-039 (HMO) (2023)Local HMO$3,700$0
4
Humana Gold Plus H1951-048 (HMO) (2023)Local HMO$3,700$0
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4

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