HumanaChoice SNP-DE H5216-268 (PPO D-SNP)

HumanaChoice SNP-DE H5216-268 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Insurance Company available for the 2026 plan year to people living in Select Counties in Iowa. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice SNP-DE H5216-268 (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 H5216-268 (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 H5216-268 (PPO D-SNP) prescription drug plan features 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 supplies filled at standard pharmacies or through preferred mail order. However, standard mail order for these generic tiers requires a copay, ranging from $10 for Tier 1 to $20 for Tier 2 for a 1-month supply. For Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance regardless of whether you use standard pharmacies, preferred mail order, or standard mail order. This 25% coinsurance applies to both 1-month and 3-month supplies for Tiers 3 and 4, and 1-month supplies for Tier 5 specialty medications. This cost-sharing structure helps Medicare beneficiaries understand their potential out-of-pocket prescription costs.

Additional Benefits

The HumanaChoice SNP-DE H5216-268 (PPO D-SNP) plan offers comprehensive medical coverage, featuring no copay and a 20% coinsurance for outpatient services, primary care, and specialist visits. Inpatient hospital stays require no coinsurance but carry a copay of $2,230 per stay for acute care and $2,080 for psychiatric care. Additionally, preventive services, annual physicals, and home health services are fully covered with no copay and no coinsurance. This plan also includes valuable supplemental benefits, such as dental coverage up to a $5,000 annual limit and eyewear up to a $400 yearly limit, both with no copay and no coinsurance. Members can also take advantage of no copay and no coinsurance for up to 100 one-way transportation trips per year, over-the-counter items, and prescription hearing aids. Emergency care is covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours.

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.