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Humana Together in Health (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Together in Health (PPO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Together in Health (PPO I-SNP) in 2025, please refer to our full plan details page.
Humana Together in Health (PPO I-SNP) is a PPO I-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Upstate South Carolina. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Together in Health (PPO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Together in Health (PPO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Together in Health (PPO I-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.
For Humana Together in Health (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $480.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Humana Together in Health (PPO I-SNP) plan has a $480 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy used. For the initial coverage phase, you will pay a $0 copay for preferred generic drugs at standard and preferred mail pharmacies, but a $20 copay at standard mail pharmacies. For other tiers, you will pay 25% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with coinsurance, and ambulance and transportation services with coinsurance or no copay. The plan also provides coverage for primary care, preventive, hearing, vision, and dental services with a mix of copays and coinsurance. This plan includes coverage for home health services, skilled nursing facility stays, and home infusion services. Additionally, it offers benefits for medical equipment, diagnostic and radiological services, and other services like acupuncture.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $598 per admission for days 1-4, and no copay for days 5-90. Additional days for Inpatient Hospital-Acute have no copay. Inpatient Hospital Psychiatric has a copay of $1872 per admission, and additional days and non-Medicare-covered stays for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Together in Health (PPO I-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay, with up to 36 one-way trips per year via taxi, bus/subway, or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Together in Health (PPO I-SNP) plan. Emergency Services and Worldwide Emergency Coverage, Urgent Coverage, and Transportation have a $110 copay, while Urgently Needed Services have a 20% coinsurance.
Primary Care See details
The Humana Together in Health (PPO I-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, occupational therapy services, physical therapy, and speech-language pathology services have no copay; however, routine chiropractic care is not covered, and specialist services, mental health services, podiatry services, other health care professional services, psychiatric services, additional telehealth benefits, and opioid treatment program services have 20% coinsurance.
Preventive Services See details
The Humana Together in Health (PPO I-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services, such as health education, in-home safety assessments, and more, are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids has no copay. Prescription hearing aids (all types) have a copay between $99 and $699, and OTC hearing aids are covered up to $75 every three months.
Vision Services See details
Vision services include coverage for eye exams, with a 20% coinsurance and no copay. Eyewear is covered, with no copay, and contact lenses and eyeglasses are covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Together in Health (PPO I-SNP) plan's dental services include coverage for Medicare Dental Services with 20% coinsurance and other dental services with a $2,000 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are also covered with no copay, and some services require prior authorization. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin and Medicare Part B drugs. Insulin has a $35 copay and a coinsurance between 0-20%, while other Medicare Part B drugs have no copay and a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The coinsurance for this benefit is 20%.
Medical Equipment See details
The Humana Together in Health (PPO I-SNP) plan covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices, Medicare-covered Prosthetic Devices, and Medicare-covered Medical Supplies with 20% coinsurance. Diabetic equipment is covered, including Diabetic Supplies with 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, and Lab Services and Outpatient X-Ray Services have a coinsurance of at most 20% with no copay.
Home Health Services See details
Home Health Services are covered by the Humana Together in Health (PPO I-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Humana Together in Health (PPO I-SNP) plan. Although the plan covers some cardiac and pulmonary rehabilitation services, it does not cover the specific services mentioned in the provided details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Together in Health (PPO I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, covered with 20% coinsurance and a limit of 20 treatments per year, and over-the-counter (OTC) items, with a maximum benefit coverage amount of $75.00 every three months, including nicotine replacement therapy and naloxone. Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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