MA 2027 plan LPPO

Humana USAA Honor Giveback (PPO)

Plan information effective January 1, 2027.

Humana Benefit Plan of Illinois, Inc. Plan ID H5525-079-000 Plan #79 MA

Plan costs & ratings

Monthly premium$0.00

Annual premium$0.00

Medical premium$0.00

Medical deductible$0

Medical out-of-pocket limit (in network)$6,500

Medical out-of-pocket limit (out of network)$10,100

Availability

Available in 11 California counties

Alpine County, CA, Calaveras County, CA, Lassen County, CA, Marin County, CA, Mariposa County, CA, Mono County, CA, Plumas County, CA, San Francisco County, CA, San Joaquin County, CA, Sierra County, CA, Stanislaus County, CA

Available Cities

This plan is available in 38+ cities in California.

Bear Valley Calaveras County Burson Calaveras County Mountain Ranch Calaveras County Valley Springs Calaveras County Janesville Lassen County Madeline Lassen County Milford Lassen County Susanville Lassen County Termo Lassen County Corte Madera Marin County Forest Knolls Marin County Kentfield Marin County Larkspur Marin County Novato Marin County San Rafael Marin County Sausalito Marin County June Lake Mono County Chester Plumas County Crescent Mills Plumas County San Francisco San Francisco County Escalon San Joaquin County French Camp San Joaquin County Lathrop San Joaquin County Lodi San Joaquin County Manteca San Joaquin County Ripon San Joaquin County Stockton San Joaquin County Tracy San Joaquin County Loyalton Sierra County Sierraville Sierra County Ceres Stanislaus County Denair Stanislaus County Modesto Stanislaus County Patterson Stanislaus County Riverbank Stanislaus County Salida Stanislaus County Turlock Stanislaus County Waterford Stanislaus County

Benefits

Primary care In Network

In-Network: $0 copay per visit

Inpatient hospital In Network

In-Network: $300 copay per day for days 1-5, $0 copay per day for days 6-90.

Skilled nursing In Network

In-Network: $10 copay per day for days 1-20, $221 copay per day for days 21-100.

Emergency care In Network

In-Network: $130 copay per visit

Urgently needed care In Network

In-Network: $50 copay for Medicare-covered urgently-needed-care visits.

Ambulance In Network

In-Network: $325 copay per trip

Dental In Network

In-Network: $0 copay

Vision In Network

This plan includes: Eye Exams, Eyewear.

Hearing In Network

In-Network: $0 copay per visit; Limit of 1 visit every year.

Transportation In Network

In-Network: $325 copay

Fitness In Network

In-Network: $0 copay for Fitness Benefit.

Plan Overview

CarrierHumana Benefit Plan of Illinois, Inc.

Plan typeMA

PlanLPPO

Marketing nameHumana

Drug coverageNot included

Enrollment hours8:00 a.m. to 8:00 p.m. Member time

Provider searchOpen provider directory

Carrier websiteOpen website

Plan identifiers

Plan IDH5525-079-000

Plan number79

ContractH5525

Segment0

DRX ID181NJ3QC0T

Carrier ID159

Carrier contact

Carrier phone8004574708

Enrollment phone8004574708

Enrollment TTY711

Carrier hours8:00 a.m. to 8:00 p.m. Member time