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HumanaChoice - Diabetes and Heart (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice - Diabetes and Heart (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice - Diabetes and Heart (PPO C-SNP) in 2026, please refer to our full plan details page.
HumanaChoice - Diabetes and Heart (PPO C-SNP) is a PPO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Mississippi. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HumanaChoice - Diabetes and Heart (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice - Diabetes and Heart (PPO C-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 - Diabetes and Heart (PPO C-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 - Diabetes and Heart (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 has a $400.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $6700.00 (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 $6700.00 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 - Diabetes and Heart (PPO C-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 6 select care drugs, you will pay no copay when using standard pharmacies or preferred mail order services. Tier 2 generic medications are also highly affordable, starting with a low $5 copay for a one-month supply at standard pharmacies or via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, with savings available on three-month supplies through preferred mail order. For higher-tier medications, Tier 4 non-preferred drugs carry a 47% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance. Understanding these copayment and coinsurance structures helps you estimate your out-of-pocket prescription costs under this Medicare plan.
Additional Benefits
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan offers comprehensive coverage with predictable costs, featuring no copays or coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, members pay low copayments, such as a $15 copay for specialist visits and no copay for routine dental cleanings. Hospital stays and emergency services are also covered, requiring a $295 daily copay for the first seven days of acute inpatient care and a $130 copay for emergency room visits. This plan provides valuable supplemental benefits to support overall wellness, including up to 48 one-way transportation trips to plan-approved locations and a $2,000 annual allowance for dental care. Vision and hearing benefits feature no copays for routine annual exams, alongside coverage for corrective eyewear and hearing aids. Additionally, members can access covered cardiac rehabilitation, physical therapy, and acupuncture services with minimal out-of-pocket costs and no coinsurance.
Inpatient Hospital See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring a daily copay of $295 for days 1-7 of acute stays and $267 for days 1-7 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
Outpatient services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a $0 to $300 copay, observation services carry a $295 copay per stay, and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with a $35.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers ground ambulance services with a $335 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $15 copay and no coinsurance. Additional benefits include physical therapy ($25 copay), mental health services ($35 copay), and podiatry ($15 copay) with no coinsurance, while chiropractic care is partially covered at a $15 copay with no coinsurance for routine visits only.
Preventive Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) provides preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay or coinsurance for fitness and in-home support, though sub-services like health education, nutritional benefits, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), offering Medicare-covered exams for a $15 copay and no coinsurance, plus routine exams and fitting evaluations with no copay. Prescription hearing aids are covered up to two per year with copays ranging from $199 to $499 and no coinsurance, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) provides partially covered vision services with no deductibles and no coinsurance, featuring one routine eye exam and eyewear (contact lenses or eyeglasses) per year with no copays. Annual benefits are limited to $40 for exams and $350 for eyewear, while other eye exam services, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), featuring a $2,000 annual maximum for combined in-network and out-of-network care. Medicare-covered dental services require a $15 copay and no coinsurance, while other covered services like cleanings, exams, and restorative care have no copay and no coinsurance; however, fluoride treatments, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Home Infusion bundled Services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers durable medical equipment (DME), prosthetics, medical supplies, and diabetic services with 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers diagnostic and radiological services, requiring prior authorization for both. Diagnostic services feature no coinsurance, with lab services costing no copay and other diagnostic tests ranging from no copay up to a $100 copay. Radiological services include outpatient X-rays with no copay, diagnostic radiology starting with no copay, and therapeutic radiology requiring a minimum 20% coinsurance and a $15 copay.
Home Health Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay, no coinsurance, and required prior authorization. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but not requiring a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers other services, offering acupuncture with a $15.00 copay and no coinsurance for up to 20 treatments per year, and a home meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
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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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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