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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 2025, 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 2025.
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 $55.60. 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 $590.00 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 $14000.00 (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 $14000.00 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:
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Drug Coverage
The HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay a certain amount depending on the drug tier until your total drug costs reach $2000. Once you reach $2000 in total drug costs, you enter the next coverage phase where you pay nothing for covered drugs.
Additional Benefits
The HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with coinsurance and copays, and partial hospitalization with coinsurance. Emergency services, primary care, and preventive services are covered. Additional benefits include coverage for hearing and vision services, dental care with no copays for many services, and home infusion services with copays or coinsurance. The plan also covers ambulance services, skilled nursing facility stays with copays, and other services like acupuncture, OTC items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, the copay is $2,185 per admission, and additional days are covered with no copay. For Inpatient Hospital Psychiatric, the copay is $2,036 per admission, and additional days are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a 20% coinsurance and a $550 copay for outpatient hospital services, and 20% coinsurance for observation services. Ambulatory Surgical Center (ASC) Services have a $400 copay and a 20% coinsurance. Outpatient Substance Abuse Services are covered with a 20% coinsurance for both individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan. Ground Ambulance Services have a $315 copay, while Air Ambulance Services have a 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan. Emergency Services have a $110 copay, Urgently Needed Services have a 20% coinsurance, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $110 copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits are covered with a 20% coinsurance. Chiropractic Services and Podiatry Services are covered with a 20% coinsurance, and Routine Chiropractic Care has no copay, while other Chiropractic Services and Medicare-covered Podiatry Services have a copay. Mental Health Specialty Services and Psychiatric Services are covered with a 20% coinsurance for individual and group sessions.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other services like wigs for hair loss, in-home support services, and smoking cessation counseling. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered, with a coinsurance of at most 20% for routine hearing exams, and no copay for routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids are partially covered, with no copay for prescription hearing aids (all types), but not for inner ear, outer ear, or over the ear hearing aids. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a 20% coinsurance and no copay, and eyewear with no copay. Contact lenses and eyeglasses (lenses and frames) are covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance, other dental services with a $2,000 maximum benefit, oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, and prosthodontics (fixed) with no copay for each service. Fluoride treatment, prosthodontics (removable), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%, and Medicare Part B Chemotherapy/Radiation Drugs have a copay.
Dialysis Services See details
Dialysis Services are covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic, and radiological services, are covered by HumanaChoice SNP-DE H5216-330 (PPO D-SNP). Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, with Diagnostic Procedures/Tests also having a copay. Diagnostic Radiological Services have a coinsurance of at most 20% and a copay of at most $720, while Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a coinsurance of at most 20% and a copay of $50.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan, with a prior authorization requirement. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day.
Other Services See details
The HumanaChoice SNP-DE H5216-330 (PPO D-SNP) plan covers acupuncture with a 20% coinsurance and a limit of 20 treatments per year, and also covers over-the-counter (OTC) items up to $1200 annually, including nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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