specific OSBs when stated in the Evidence of Coverage (EOC); otherwise, covered services may be received from 
non-network providers at ahigher cost. Enrollees must continue to pay the Medicare Part Bpremium, their 
Humana premium, and the OSB premium. 
Humana.com H5216107000SB23 Summary of Benefits 27 H5216107000 
GHHLNNXEN 0522 Important________________________________________________ 
At Humana, it is important you are treated fairly.