A non-government entity
Humana Together in Health (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Together in Health (PPO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Together in Health (PPO I-SNP) in 2025, please refer to our full plan details page.
Humana Together in Health (PPO I-SNP) is a PPO I-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Together in Health (PPO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Together in Health (PPO I-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 Humana Together in Health (PPO I-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 Humana Together in Health (PPO I-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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $500.00 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 Humana Together in Health (PPO I-SNP) plan has a $500 deductible for prescription drugs. After the deductible, you will pay the following costs for drugs in each tier until your total drug costs reach $2,000. For preferred generic drugs at a standard pharmacy, there is no copay. For standard mail order, there is a $20 copay. For all other tiers and pharmacies, you will pay 25% coinsurance. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a copay of $598 per day for days 1-4 and $1872 per admission for psychiatric stays, while outpatient services, ambulance services, emergency services, and many other services have a 20% coinsurance. The plan also includes benefits with no copay, such as primary care visits, hearing exams, vision eyewear, home health services, and skilled nursing facility stays for the first 100 days. Other benefits include coverage for prescription hearing aids, dental services, and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric inpatient hospital stays. For Inpatient Hospital-Acute, you will pay a copay of $598 per day for days 1-4, and no copay for days 5-90, while Additional Days have no copay. Inpatient Hospital Psychiatric has a copay of $1872 per admission or stay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital and Observation Services have a 20% coinsurance. Ambulatory Surgical Center Services and Outpatient Substance Abuse Services have a coinsurance of 20%. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a 20% coinsurance, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Together in Health (PPO I-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to a plan-approved health-related location are covered with no copay, up to 36 one-way trips per year. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, have a $110 copay. Urgently Needed Services have a 20% coinsurance with no copay.
Primary Care See details
The Humana Together in Health (PPO I-SNP) plan covers primary care physician services and chiropractic services with no copay, but chiropractic services require prior authorization. Specialist services, mental health specialty services, podiatry services, other healthcare professional services, psychiatric services, and opioid treatment program services are covered with 20% coinsurance. Physical therapy and speech-language pathology services are covered with no copay and no coinsurance. Additional telehealth benefits are covered with a 20% coinsurance and no copay. Routine chiropractic care is not covered.
Preventive Services See details
The Humana Together in Health (PPO I-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services like Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing Services includes coverage for routine hearing exams with no copay and a 20% coinsurance, and fitting/evaluation for hearing aids with no copay and no coinsurance. Prescription Hearing Aids (all types) have a copay between $99 and $699, and OTC hearing aids are covered up to $75 every three months. However, Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
Vision Services include eye exams, with a 20% coinsurance and no copay, and eyewear, with no copay. The plan covers one routine eye exam and one pair of contact lenses or eyeglasses (lenses and frames) per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance and other dental services with a $2,000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, prosthodontics, fixed, and oral and maxillofacial surgery are covered with no copay. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Humana Together in Health (PPO I-SNP) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, and the coinsurance for all Medicare Part B drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Humana Together in Health (PPO I-SNP) plan, with a coinsurance of 20%. Prior authorization is required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay and 20% coinsurance, while 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 are covered, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic procedures/tests, diagnostic radiological services, and therapeutic radiological services have a coinsurance of at most 20%, while lab services and outpatient X-ray services have a coinsurance of at most 20% with no copay.
Home Health Services See details
Home Health Services are covered by the Humana Together in Health (PPO I-SNP) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Humana Together in Health (PPO I-SNP) plan. Although the plan covers Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services, these services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Together in Health (PPO I-SNP), with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Together in Health (PPO I-SNP) plan covers acupuncture with a 20% coinsurance and requires prior authorization, with a limit of 20 treatments per year. Over-the-counter (OTC) items are also covered, with a maximum benefit of $75 every three months, including nicotine replacement therapy and naloxone. However, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
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