HumanaChoice Giveback H5216-309 (PPO)

HumanaChoice Giveback H5216-309 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Indiana, Ohio, & N KY. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice Giveback H5216-309 (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 Giveback H5216-309 (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 Giveback H5216-309 (PPO) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay for 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs require a $10 copay for a 1-month supply, while Tier 2 drugs carry a $20 copay. For Tier 3 preferred brand drugs, you will pay a $30 copay for a 1-month supply at standard pharmacies or through preferred mail order, compared to a $47 copay through standard mail order. Tier 4 non-preferred drugs require a 35% coinsurance across all standard pharmacy, preferred mail-order, and standard mail-order options. Specialty medications in Tier 5 are subject to a 33% coinsurance for a 1-month supply regardless of whether you use a standard pharmacy, preferred mail order, or standard mail order.

Additional Benefits

The HumanaChoice Giveback H5216-309 (PPO) plan offers affordable medical coverage, featuring no copays or coinsurance for preventive services, primary care doctor visits, and home health care. Specialist visits and urgent care require a $40 copay, while emergency room visits have a $115 copay. For hospital care, inpatient stays require a $400 copay for the first five days and no copay thereafter, while outpatient hospital visits range from no copay up to a $400 copay. Supplemental benefits include routine dental, vision, and hearing services, which feature no copays or coinsurance for basic exams and preventive care. Skilled nursing facility stays are also covered, requiring no copay for the first 20 days. For medical supplies and specialized services, members pay a 13% coinsurance for durable medical equipment and a 20% coinsurance for dialysis with no copays.