HumanaChoice SNP-DE H5216-267 (PPO D-SNP)

HumanaChoice SNP-DE H5216-267 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Colorado. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice SNP-DE H5216-267 (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 H5216-267 (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 H5216-267 (PPO D-SNP) plan has an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, there is no copay for 1-month and 3-month prescriptions filled at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs have a $10 copay for a 1-month supply ($30 for 3-month), and Tier 2 drugs have a $20 copay for a 1-month supply ($60 for 3-month). For higher-tier medications, including Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance applies to standard pharmacies, preferred mail order, and standard mail order for both 1-month and 3-month supplies of Tier 3 and Tier 4 drugs, as well as 1-month supplies of Tier 5 specialty drugs.

Additional Benefits

The HumanaChoice SNP-DE H5216-267 (PPO D-SNP) plan offers comprehensive medical coverage, with many outpatient services, primary care, and specialist visits requiring no copay and a 20% coinsurance. Inpatient hospital stays require a $1,950 copay per stay with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. For skilled nursing facilities, members enjoy no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. This plan also features robust supplemental benefits, including preventive care, home health services, and over-the-counter items with no copay and no coinsurance. Dental services are covered up to a $4,000 annual limit, featuring no copay and no coinsurance for routine care, while routine vision and hearing exams generally require no copay and a 20% coinsurance. Additionally, members can access up to 36 one-way transportation trips per year to plan-approved locations with no copay or coinsurance.