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L3 Harris - H5216-805-249
$161.59
Monthly Premium
L3 Harris is a Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H5216-805-249
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$161.59
Monthly Premium
Mississippi Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Mississippi Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Enrollment may be limited to certain times of the year. See why you may be able to enroll.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $161.59 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $0.00 |
| Out-of-pocket maximum | $1,750.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $2,000.00 |
| Primary care doctor visit | In or Out of Network: 5% coinsurance |
| Specialty doctor visit | In or Out of Network: 5% coinsurance |
| Inpatient hospital care | In or Out of Network: $300 copayment per admission |
| Urgent care | In or Out of Network: 5% coinsurance |
| Emergency room visit | In or Out of Network: 5% coinsurance, waived if admitted within 24 hours |
| Ambulance transportation | In or Out of Network: 5% coinsurance per date of service, Limited to Medicare-covered transportation. |
Health Care Services and Medical Supplies
L3 Harris covers a range of additional benefits. Learn more about L3 Harris benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | In Network: Chiropractic Services (Medicare Covered) 5% coinsurance Chiropractic Services (Routine) 20% coinsurance for routine chiropractic visits up to 20 combined in and out of network visit(s) per year. |
| Diabetes supplies, training, nutrition therapy and monitoring | Diabetes Self-Management Services Diabetes Self-Management Services: In or Out of Network: 0% coinsurance Diabetes Supplies and Services Diabetes Supplies and Services: In or Out of Network: $0 copayment or 5% coinsurance |
| Durable medical equipment (DME) | In or Out of Network: 5% coinsurance |
| Diagnostic tests, lab and radiology services, and X-rays | Diagnostic Tests, Lab and Radiology Services, and X-Rays Diagnostic Tests, Lab and Radiology Services, and X-Rays: In or Out of Network: 0% - 5% coinsurance Medicare-Covered diagnostic procedures and tests Medicare-Covered diagnostic procedures and tests: In or Out of Network: 0% - 5% coinsurance Medicare-covered diagnostic radiology services (not including x-rays) Medicare-covered diagnostic radiology services (not including x-rays): In or Out of Network: 5% coinsurance Medicare-covered lab services Medicare-covered lab services: In or Out of Network: 5% coinsurance Medicare-covered therapeutic radiology services Medicare-covered therapeutic radiology services: In or Out of Network: 5% coinsurance Medicare-covered X-rays Medicare-covered X-rays: In or Out of Network: 5% coinsurance |
| Home health care | In or Out of Network: 0% coinsurance, Excludes Personal Home Care. |
| Mental health inpatient care | In or Out of Network: $300 copayment per admission, 190 day lifetime limit in a psychiatric facility. |
| Mental health outpatient care | In or Out of Network: 5% coinsurance |
| Outpatient services/surgery | Ambulatory Surgical Center Ambulatory Surgical Center: In or Out of Network: 0% - 5% coinsurance Observation Services Observation Services: In or Out of Network: 5% coinsurance, waived if admitted within 24 hours Outpatient Services/Surgery Outpatient Services/Surgery: In or Out of Network: 5% coinsurance |
| Outpatient substance abuse care | Opioid Treatment: In or Out of Network: 5% coinsurance Outpatient Substance Abuse: In or Out of Network: 5% coinsurance |
| Podiatry services | Out of Network: Podiatry Services (Medicare Covered) 5% coinsurance Podiatry Services (Routine) 20% coinsurance for routine podiatry visits up to unlimited combined in and out of network visit(s) per year. Benefits received out-of-network are subject to any in-network benefit maximums, limitations, and/or exclusions. |
| Skilled Nursing Facility (SNF) care | In or Out of Network: $0 copayment per day for days 1-20, $37 copayment per day for days 21-100, 20% coinsurance per day for days 101-120, Plan pays $0 after 120 days. |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | In or Out of Network: Dental Services (Medicare Covered) 5% coinsurance |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage
| Coverage | Details |
|---|---|
| Vision care | Medicare-covered Eyewear Medicare-covered Eyewear: In or Out of Network: 5% coinsurance, For eyeglasses and contacts following cataract surgery. Vision Services Vision Services: In or Out of Network: Vision Services (Medicare Covered) 5% coinsurance |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing care | Out of Network: Hearing Services (Medicare Covered) 5% coinsurance Hearing Services (Routine) $0 copayment for routine hearing exams up to 1 per year, up to $45 maximum benefit coverage. $600 maximum benefit coverage amount for each hearing aid(s) (all types) up to 1 per ear per year. Note: Members must contact TruHearing to utilize Out of Network benefits. Benefits received out-of-network are subject to any in-network benefit maximums, limitations, and/or exclusions. The approved provider, TruHearing, must be used in order to obtain benefits. |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | Glaucoma Screening Glaucoma Screening: In or Out of Network: 0% coinsurance Preventive Services Preventive Services: In or Out of Network: $0 copayment |
When reviewing Mississippi Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Mississippi that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Mississippi Counties Served
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.