HumanaChoice H5216-203 (PPO)

HumanaChoice H5216-203 (PPO) is a PPO plan offered by Humana Insurance Company available for the 2026 plan year to people living in Select counties in Georgia. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice H5216-203 (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about HumanaChoice H5216-203 (PPO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The HumanaChoice H5216-203 (PPO) plan features a $350 annual drug deductible. Under this plan, Tier 1 preferred generic drugs have no copay for 1-month or 3-month supplies at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost a $5 copay for a 1-month supply at standard pharmacies, but they feature no copay for a 3-month supply when ordered through preferred mail. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply, while 3-month supplies range from $131 to $141 depending on your pharmacy choice. For higher-tier prescriptions, Tier 4 non-preferred drugs require a 47% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance.

Additional Benefits

The HumanaChoice H5216-203 (PPO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized care, members pay a $20 copay for specialist visits, a $35 copay for partial hospitalization, and a $375 daily copay for the first several days of inpatient hospital stays. Emergency services and urgently needed care are also covered with no coinsurance, featuring a $115 copay and a $40 copay respectively. This plan also features supplemental benefits, including routine dental care with no copay up to a $1,500 annual limit and routine vision and hearing exams with no copay or coinsurance. Prescription hearing aids are covered with copays ranging from $699 to $999, while covered eyewear is available with no copay up to a $150 annual limit. Additionally, diagnostic lab services and outpatient X-rays carry no copay, while durable medical equipment is covered with a 20% coinsurance and no copay.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.