HumanaChoice H5216-316 (PPO)

HumanaChoice H5216-316 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Oklahoma. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice H5216-316 (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 H5216-316 (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 H5216-316 (PPO) Medicare plan features an annual prescription drug deductible of $420. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, starting at a $9 copay for a 1-month supply at standard pharmacies, with no copay for a 3-month supply when ordered through preferred mail. For Tier 3 preferred brand drugs, the plan requires a $47 copay for a 1-month supply across standard pharmacies and mail-order options, with a reduced cost of $131 for a 3-month supply via preferred mail order. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 48% coinsurance and Tier 5 specialty drugs requiring a 28% coinsurance. These structured pharmacy benefits help you easily estimate and manage your out-of-pocket prescription expenses.

Additional Benefits

The HumanaChoice H5216-316 (PPO) Medicare plan offers comprehensive coverage with no copays and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a $290 daily copay for the first five days and no copay for days six through 90, with no coinsurance required. Outpatient hospital services and specialist visits are also highly affordable, featuring no coinsurance and low copays ranging from no copay up to $250 depending on the specific service. This plan also includes valuable dental, vision, and hearing benefits, offering no copays for routine eye exams, covered eyewear, and preventive dental services up to a $2,000 annual limit. While emergency care requires a $130 copay and ambulance services require a $335 copay, both feature no coinsurance. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay, ensuring predictable out-of-pocket costs for essential medical needs.