HumanaChoice SNP-DE H5216-205 (PPO D-SNP)

HumanaChoice SNP-DE H5216-205 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 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 SNP-DE H5216-205 (PPO D-SNP) 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 SNP-DE H5216-205 (PPO D-SNP).

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 SNP-DE H5216-205 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Beneficiaries pay no copay for Tier 1 preferred generics and Tier 2 generics when using a standard pharmacy or preferred mail order. For standard mail order, Tier 1 generics have a $10 copay for a 1-month supply ($30 for 3-month), and Tier 2 generics have a $20 copay ($60 for 3-month). For Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% coinsurance applies to standard pharmacies, preferred mail order, and standard mail order. The coinsurance covers both 1-month and 3-month supplies for Tiers 3 and 4, and 1-month supplies for Tier 5.

Additional Benefits

The HumanaChoice SNP-DE H5216-205 (PPO D-SNP) plan covers primary care and outpatient hospital services with no copay and a 20% coinsurance. Inpatient acute care stays require a $2,230 copay per stay with no coinsurance, while emergency room visits carry a $115 copay. Preventive services, such as annual physicals and screenings, are covered with no copay and no coinsurance. For additional care, the plan features home health services, routine eyewear, and preventive dental care up to a $1,000 annual limit with no copay and no coinsurance. Routine hearing and vision exams require no copay and a 20% coinsurance, while prescription hearing aids are covered with no copay or coinsurance. Skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.