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Humana Value (PFFS) (Humana) — Florida Medicare Advantage Plan

Mitchell Budwig, Licensed Insurance Agent

By Mitchell Budwig, Licensed Insurance Agent

Humana Value (PFFS) is a PFFS Medicare Advantage plan from Humana with a $35 monthly premium, a CMS rating of 3.5 out of 5 stars, and a $7,550 annual out-of-pocket maximum. Prescription drug coverage is not included. Included benefits: vision, hearing.

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At a glance

Humana Value (PFFS) at a glance
DetailValue
Monthly plan premium$35 per month
Annual medical deductible$0
Annual out-of-pocket maximum$7,550
CMS star rating3.5 out of 5 stars
Plan typePFFS
Contract / plan IDH2649-011

What this plan covers

Medical (Part B)

A Private Fee-for-Service plan: you may see any Medicare provider in the United States who agrees to the plan's terms of payment, with no network to check.

Hospital (Part A)

Part A hospital and skilled nursing coverage on the same fee-for-service basis.

Prescription drugs (Part D)

No Part D included. Pair with a standalone prescription drug plan.

Extra benefits

  • Vision
  • Hearing

Costs and copays

Typical copays for Humana Value (PFFS)
ServiceYou pay in network
Primary care visit$0
Specialist visit$50
Urgent care$40
Emergency room$120 (waived if admitted)
Inpatient hospital (per stay)$350 per day, days 1–5
Lab work$0
Diagnostic imaging (MRI, CT)$225
Generic drugs (Tier 1)Not covered — add a standalone Part D plan
Preferred brand drugs (Tier 3)Not covered — add a standalone Part D plan

Typical in-network cost sharing. Amounts shown are standard cost shares for this plan and can change each plan year — always confirm against the plan's Summary of Benefits before enrolling.

Who this plan may fit

  • People in rural counties where HMO and PPO networks are thin
  • Anyone who wants to keep seeing a provider who is not in any Advantage network
  • People who already have prescription coverage elsewhere

Who it may not suit

Providers can decide visit by visit whether to accept the plan's terms, so you must confirm acceptance each time. Extra benefits are also lighter than on HMO and PPO plans.

How to use this plan

Finding in-network providers
Search the carrier's online provider directory by name, specialty, and ZIP code, or call us and we will check your doctors against the network before you enroll.
Do you need referrals?
No referral is required. You can see any participating specialist directly.
How prior authorization works
Certain services — planned inpatient stays, advanced imaging, some outpatient surgeries, durable medical equipment, and specialty drugs — need approval before the plan pays. Your provider submits the request; ask them to confirm approval before scheduling.
Traveling and coverage away from home
You are covered nationwide for urgent and emergency care, and this plan also pays for routine care from out-of-network providers who accept the plan, at a higher cost share.

How to enroll in this plan

You can join this plan when you first become eligible for Medicare, during your seven-month Initial Enrollment Period around your 65th birthday.

After that, the Annual Enrollment Period runs October 15 to December 7 each year, with coverage starting January 1. If you are already in a Medicare Advantage plan, Medicare Advantage Open Enrollment from January 1 to March 31 lets you make one switch.

Outside those windows, a qualifying life event such as a move, a loss of employer coverage, or a change in Medicaid eligibility can open a Special Enrollment Period that lets you enroll right away.

Enroll Into Plan Today

Takes about a minute · A licensed agent completes the application with you

Open enrollment datesSpecial enrollment periods

Answer These Quick Questions to Enroll Into Humana Today

Enroll into Humana Value (PFFS)

Send your details and a licensed agent will call you to confirm your eligibility, check your doctors and prescriptions against Humana Value (PFFS), and complete the Humana application with you over the phone. Nothing is submitted to Humana until you approve it.

The plan you're inquiring about

Plan:
Humana Value (PFFS)
Carrier:
Humana
Plan type:
PFFS
Monthly premium:
$35 per month
CMS rating:
3.5 out of 5 stars
Plan ID:
H2649-011

Looking at a different plan? Compare all Florida plans

No cost, no obligation. Medicare caps what an agent can be paid, and the carrier pays it whether you enroll with us or on your own. Your premium is exactly the same either way. We never sell your information, and you can ask us to stop contacting you at any time.

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Monday – Friday, 8:00 am – 8:00 pm ET · Saturday, 9:00 am – 5:00 pm ET

Check whether this plan covers your doctors and prescriptions

A licensed agent will run your providers and medication list against this plan before you enroll, and show you the comparable plans in your county so you can see the trade-offs.

Monday – Friday, 8:00 am – 8:00 pm ET · Saturday, 9:00 am – 5:00 pm ET

Questions about this plan

How much does Humana Value (PFFS) cost each month?

The plan premium is $35 per month. You also continue to pay your Medicare Part B premium, which goes to Medicare rather than to Humana. Beyond premiums you pay copays as you use services, up to an annual out-of-pocket maximum of $7,550.

Does Humana Value (PFFS) include prescription drug coverage?

No. This plan does not include Part D, so you need drug coverage from another creditable source such as the VA, an employer plan, or a standalone Part D plan. Going without creditable coverage can trigger a permanent late enrollment penalty.

Do I need a referral to see a specialist on Humana Value (PFFS)?

No referral is required. You can see any participating specialist directly.

What is the CMS star rating for Humana Value (PFFS)?

Medicare rates this plan 3.5 out of 5 stars. Star ratings measure things like preventive care, member experience, customer service, and how quickly problems get resolved. Ratings are published each fall and can change from year to year.

Which Florida counties can I enroll in Humana Value (PFFS)?

CMS approved this plan in 17 Florida counties. Medicare Advantage plans are approved county by county, so your eligibility depends on the address where you actually live.

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