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HumanaChoice SNP-DE H5216-330 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H5216-330 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice SNP-DE H5216-330 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Louisiana. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice SNP-DE H5216-330 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice SNP-DE H5216-330 (PPO D-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 HumanaChoice SNP-DE H5216-330 (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.
For HumanaChoice SNP-DE H5216-330 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.90. 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 $615.00 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 $13900.00 (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 $13900.00 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:
Sign up for HumanaChoice SNP-DE H5216-330 (PPO D-SNP)
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Drug Coverage
The HumanaChoice SNP-DE H5216-330 (PPO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay for 1-month and 3-month fills at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs have a $10 to $30 copay, while Tier 2 drugs carry a $20 to $60 copay. For Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacies, preferred mail order, and standard mail order for both 1-month and 3-month supplies.
Additional Benefits
The HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan offers robust medical coverage, featuring preventive services and home health care with no copay and no coinsurance. For everyday medical needs, primary care visits require no copay and a 20% coinsurance, while emergency room visits incur a $115 copay that is waived upon hospital admission. Inpatient acute hospital stays require a $2,230 copay per stay with no coinsurance, and skilled nursing facility care is available with no copay for the first 20 days. This plan also includes key supplemental benefits, providing dental, vision, and hearing services with no copay and no coinsurance up to specific plan limits. Dental care is covered up to a $2,000 yearly limit, and eyewear is covered up to $150 annually, helping to minimize your out-of-pocket costs. Additionally, over-the-counter items and diagnostic lab services are available with no copay, though many specialized services and medical equipment require prior authorization and a 20% coinsurance.
Inpatient Hospital See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a copayment of $2,230 per acute stay and $2,080 per psychiatric stay. While unlimited additional days are covered for acute care with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers outpatient hospital services with a $555 copay and 20% coinsurance, and ambulatory surgical center services with a $475 copay and 20% coinsurance. Outpatient substance abuse and blood services are covered with no copay and 20% coinsurance, with prior authorization required for these outpatient services.
Partial Hospitalization See details
Partial hospitalization services are covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers ground ambulance services with a $335 copay and coinsurance, and air ambulance services with a 20% coinsurance and a copay, with prior authorization required for both. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP) for a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 20% coinsurance (up to $40), while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Primary care benefits under HumanaChoice SNP-DE H5216-330 (PPO D-SNP) are generally covered with no copay and 20% coinsurance, with prior authorization required for most specialty, therapy, and mental health services. Chiropractic care is partially covered, offering up to 12 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP) with no copay and no coinsurance for annual exams, kidney disease education, and select screenings. Additional preventive benefits are partially covered with no copay and no coinsurance, but exclude health education, personal emergency response systems, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, disease management, telemonitoring, remote access, home safety modifications, and counseling. Covered additional benefits like wigs, fitness, in-home support, and tobacco cessation counseling require prior authorization.
Hearing Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) provides partially covered hearing services with no copay and a 20% coinsurance for annual routine hearing exams, and no copay or coinsurance for fitting evaluations and OTC hearing aids. Prescription hearing aids are covered with no copay or coinsurance for up to two devices every three years, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) partially covers vision services, offering routine eye exams with no copay and 20% coinsurance up to a $75 annual limit, while other eye exams are not covered. Covered eyewear, such as eyeglasses and contact lenses, has no copay and no coinsurance up to a $150 yearly limit, but separate eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP), featuring Medicare-covered dental with no copay and a 20% coinsurance, and other covered services with no copay and no coinsurance up to a $2,000 annual limit. Non-covered services include fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled services are covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan, requiring prior authorization and step therapy. Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers diagnostic and radiological services subject to prior authorization and a minimum 20% coinsurance. Under this plan, lab services have no copay, outpatient X-rays require a $50 copay, diagnostic radiological services have a minimum $200 copay, and other diagnostic procedures and therapeutic radiological services also require copayments.
Home Health Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP) with no copay, but only some services are covered in practice; standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and no three-day prior hospital stay is needed, though additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
HumanaChoice SNP-DE H5216-330 (PPO D-SNP) partially covers other services, offering acupuncture with no copay and 20% coinsurance, alongside over-the-counter items and meal benefits with no copay and no coinsurance. Highly integrated services and other additional services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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