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| The HumanaOne® Enhanced Copay 80% Plan - Copays for doctor's office visits, prescription coverage, low deductible options and 80% coverage for most covered expenses after deductible
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| Eligibility - People between the ages of two weeks and sixty four and a half years of age can apply for HumanaOne health plans. A dependent child must be 27 years of age or younger. |
Effective date - If you've had major medical coverage in the last 63 days, your start date can be as early as the day you apply. If you haven't had coverage in the last 63 days, you'll have two start dates:
1. Subject to approval, your plan starts on the day you request, with coverage for preventive care and injuries caused by an accident
2. Unless Humana agrees to an earlier date, your start date for sickness begins on the 15th day after the approved effective date of your plan. |
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In-network |
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Out-of-network |
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Individual: |
Family: |
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Individual: |
Family: |
Choose your medical deductible - The amount of covered expenses you’ll pay out of your pocket before your plan begins to pay its share
 Important to know:
- Deductibles start over each new calendar year
- Once three family members meet their individual deductibles, the family deductible will be met for all other family members
- For families with two people, only two individual deductibles need to be met
- This plan may include a separate deductible for certain conditions; see the deductible information on page 4 of the summary of benefits
- The medical deductible is separate from other deductibles; expenses applied to the medical deductible won't apply to mental health, prescription drugs, or condition-specific deductibles
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$ 1,000 |
$ 3,000 |
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$ 2,000 |
$ 6,000 |
| $ 1,500 |
$ 4,500 |
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$ 3,000 |
$ 9,000 |
| $ 2,000 |
$ 6,000 |
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$ 4,000 |
$ 12,000 |
| $ 2,500 |
$ 7,500 |
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$ 5,000 |
$ 15,000 |
| $ 3,500 |
$ 10,500 |
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$ 7,000 |
$ 21,000 |
| $ 5,000 |
$ 15,000 |
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$ 10,000 |
$ 30,000 |
| Coinsurance - The percentage of covered healthcare costs you have to pay while covered under this plan |
You pay 20% of covered expenses after you pay your deductible |
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You pay 40% of covered expenses after you pay your deductible |
| Your out-of-pocket coinsurance maximum - The amount you're required to pay toward the covered cost of your healthcare; premium, deductibles, access fees and copays don't apply |
Individual:
$ 2,500 |
Family:
$ 5,000 |
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Individual:
$ 10,000 |
Family:
$ 20,000 |
| Each covered persons coinsurance applies to meet this maximum |
| Lifetime maximum - The total amount your plan will pay for covered expenses in your lifetime |
Unlimited |
To view Medical Limitations and Exclusions or Dental Limitations and Exclusions, please download a Summary of Benefits.
Membership in the Peoples' Benefit Alliance (PBA) is required, at an additional cost, in order to be eligible to apply for this health plan. The PBA is a not-for-profit membership organization that provides health, travel, consumer, and business-related discounts to its members. |