Humana Value (PFFS) (Humana) — Florida Medicare Advantage Plan
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.
Takes about a minute · A licensed agent completes the application with you
At a glance
| Detail | Value |
|---|---|
| Monthly plan premium | $35 per month |
| Annual medical deductible | $0 |
| Annual out-of-pocket maximum | $7,550 |
| CMS star rating | 3.5 out of 5 stars |
| Plan type | PFFS |
| Contract / plan ID | H2649-011 |
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
| Service | You 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.
Where this plan is available (17 counties)
Select your county to see everything available where you live. Eligibility is based on your permanent address.
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.
Takes about a minute · A licensed agent completes the application with you
Answer These Quick Questions to Enroll Into Humana Today
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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