2018 HumanaChoice R3887-002 (Regional PPO) R3887-2-0 in MI from Humana | HealthPocket

HumanaChoice R3887-002 (Regional PPO)

Medicare Advantage Plan for Michigan

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderHumana
Plan IDR3887-2-0
CMS Rating1
Plan TypeRegional PPO
Annual Deductible$405.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$10,000 In and Out-of-network $6,700 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$20.00
Monthly Health Plan Premium
$113.00

Benefits

Service
Cost
Inpatient hospital coverage
In-Network:
$295 for days 1 through 6
$0 for days 7 through 90
$0 for days 91 and beyond
Out-of-Network:
50% per stay
Outpatient hospital coverage
In-Network:
$295 per visit
Out-of-Network:
50% per visit
Doctor visits
Primary:
In-Network:
$15 per visit
Out-of-Network:
50% per visit
Specialist:
In-Network:
$50 per visit
Out-of-Network:
50% per visit
Preventive care
In-Network:
$0 copay
Out-of-Network:
$0 or 50%
Emergency care/Urgent care
Emergency:
$80 per visit (always covered)
Urgent care:
$15-50 or 50% per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
In-Network:
$0-100
Out-of-Network:
50%
Lab services:
In-Network:
$0-40
Out-of-Network:
50%
Diagnostic radiology services (e.g., MRI):
In-Network:
$15-295
Out-of-Network:
50%
Outpatient x-rays:
In-Network:
$15-100
Out-of-Network:
50%
Mental health services
In-Network:
$270 for days 1 through 6
$0 for days 7 through 90
Out-of-Network:
50% per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:
$40
Out-of-Network:
50%
Outpatient individual therapy visit with a psychiatrist:
In-Network:
$40
Out-of-Network:
50%
Outpatient group therapy visit:
In-Network:
$40
Out-of-Network:
50%
Outpatient individual therapy visit:
In-Network:
$40
Out-of-Network:
50%
Skilled Nursing Facility
In-Network:
$0 for days 1 through 20
$167.50 for days 21 through 100
Out-of-Network:
50% per stay
Rehabilitation services
Occupational therapy visit:
In-Network:
$40
Out-of-Network:
50%
Physical therapy and speech and language therapy visit:
In-Network:
$40
Out-of-Network:
50%
Ambulance
In-Network:
$265 or 20%
Out-of-Network:
$265 or 20%
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
In-Network:
$50
Out-of-Network:
50%
Routine foot care:
Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
In-Network:
20% per item
Out-of-Network:
30% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:
20% per item
Out-of-Network:
40% per item
Diabetes supplies:
In-Network:
$0 or 10-20% per item
Out-of-Network:
40% per item
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
In-Network:
20%
Out-of-Network:
50%
Other Part B drugs:
In-Network:
20%
Out-of-Network:
50%

Coverage Area for HumanaChoice R3887-002 (Regional PPO)

StateMichigan
CountyWayne

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic19% coinsurance25% coinsurance19% coinsurance
Tier 2: Non-Preferred Generic25% coinsurance25% coinsurance25% coinsurance
Tier 3: Preferred Brand Name25% coinsurance25% coinsurance25% coinsurance
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsurance25% coinsurance
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic19% coinsurance25% coinsurance19% coinsurance
Tier 2: Non-Preferred Generic25% coinsurance25% coinsurance25% coinsurance
Tier 3: Preferred Brand Name25% coinsurance25% coinsurance25% coinsurance
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsurance25% coinsurance
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept HumanaChoice R3887-002 (Regional PPO) for Michigan

/
Zouabi, Firas
18311 W Warren Ave
Detroit, MI 48228
Amouzegar, Syed
16810 W Warren Ave
Detroit, MI 48228
Eubanks, Prince
20526 Plymouth Rd
Detroit, MI 48228
Ghaith, Saleh
16921 W Warren Ave Ste B
Detroit, MI 48228
Saad, George
20526 Plymouth Rd Ste C
Detroit, MI 48228
Prechel, William
16551 W Warren Ave
Detroit, MI 48228
Obeid, Zafer
16921 W Warren Ave
Detroit, MI 48228
Khanzode, Satish
20720 Plymouth Rd
Detroit, MI 48228
Signori, Enrique
4900 Mercury Dr
Dearborn, MI 48126
Sawalha, Sameer
8740 W Warren
Dearborn, MI 48126
Berri, Ziad
14515 Ford Rd
Dearborn, MI 48126
Selitsky, Benson
5050 Schaefer Rd
Dearborn, MI 48126
Stefan, Natalie
5500 Auto Club Dr
Dearborn, MI 48126
Mohamed, Tahir
6050 Greenfield Rd
Dearborn, MI 48126
Wolffing, Byron
Henry Ford Health System
Dearborn, MI 48126
Elmenini, Mohammad
10645 W Warren Ave
Dearborn, MI 48126
Thomas, Alexander
7243 Chase Rd
Dearborn, MI 48126
Webb, Deborah
7870 Oakman Blvd
Dearborn, MI 48126
Lytle, Nelson
Henry Ford Health System
Dearborn, MI 48126
Mira, Alaaeldin
Oakwood Healthcare Center Mercury Drive
Dearborn, MI 48126
Kratkoczki, Pamela
Henry Ford Health System
Dearborn, MI 48126
Cassen, Elaine
Henry Ford Health System
Dearborn, MI 48126
Details
Firas Zouabi, M.D
Phone Number
(313) 271-2800
Office Locations
18311 W Warren Ave
Detroit, MI 48228
18311 W Warren Ave Detroit MI, 48228

Similar Plans

PremiumPlan NameCMS Rating
from $12
EnvisionRxPlus (PDP)
Details
from $29
SilverScript Choice (PDP)
Details
from $17
Aetna Medicare Rx Select (PDP)
Details
from $22
Express Scripts Medicare - Saver (PDP)
Details
from $20
Humana Walmart Rx Plan (PDP)
Details

Related Articles

Related Searches

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

{}