HumanaChoice H5216-231 (PPO)

HumanaChoice H5216-231 (PPO) is a PPO plan offered by Humana Insurance Company available for the 2026 plan year to people living in Select Counties in Arkansas. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice H5216-231 (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 H5216-231 (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 H5216-231 (PPO) Medicare plan features an Enhanced Alternative drug benefit with a $420 annual prescription drug deductible. Once you meet this deductible, you will pay a $9 copay for Tier 1 preferred generics at standard pharmacies and preferred mail, or a $47 copay for Tier 2 standard generics. Tier 3 preferred brands and Tier 4 non-preferred drugs require a 46% and 28% coinsurance respectively. For individuals who qualify for the low-income subsidy, this plan offers no copay for Part D coverage. After your total yearly out-of-pocket drug costs reach $2,100, you will enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescription drugs. This plan provides clear cost-sharing phases to help you manage your annual medication expenses.

Additional Benefits

The HumanaChoice H5216-231 (PPO) plan offers robust coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $295 copay per day for the first six days and no copay for days 7 through 90, while outpatient hospital services range from no copay up to a $375 copay. Specialist visits and mental health services are also affordable, requiring copays between $15 and $35 with no coinsurance. This plan also includes valuable supplemental benefits, such as dental coverage up to a $1,500 annual limit with no copay for most diagnostic and preventive care. Routine vision and hearing exams are available with no copay, alongside a $200 annual eyewear limit and coverage for prescription hearing aids with a copay. While emergency services are covered with a $130 copay, certain services such as cardiac rehabilitation, transportation, and over-the-counter items are not covered.

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.