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 2026, 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 2026.
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 $24.60. 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 $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:
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Drug Coverage
The Humana Together in Health (PPO I-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before the plan's coverage begins to pay its share. Specific drug tier details, including copayments and coinsurance rates, are not available for this plan. To fully understand your potential out-of-pocket costs, it is recommended to check the plan formulary for your specific prescription drugs.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care, preventive services, home health care, and skilled nursing facility stays. For inpatient hospital care, members pay a $611 daily copay for the first four days and no copay for subsequent days, while emergency room visits require a $115 copay. Most specialist visits, outpatient hospital services, and diagnostic tests are covered with no copay and a 20% coinsurance. This plan also features robust supplemental benefits, including dental care up to a $2,000 annual limit and vision eyewear up to a $550 annual limit with no copay and no coinsurance. Routine hearing and vision exams are covered with no copay and a 20% coinsurance, while over-the-counter items and select hearing aids are available with no copay and no coinsurance. Medicare Part B covered insulin carries a $35 copay, while other Part B drugs require no copay and up to a 20% coinsurance.
Inpatient Hospital See details
Humana Together in Health (PPO I-SNP) partially covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute inpatient stays incur a $611 daily copay for days 1 to 4 with no copay for days 5 and beyond, while psychiatric stays require a $1,872 copay per stay; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Together in Health (PPO I-SNP) covers outpatient services with no copays, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay, no coinsurance, and no deductible, with prior authorization required for most of these outpatient benefits.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Together in Health (PPO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this service.
Ambulance and Transportation Services See details
Humana Together in Health (PPO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Humana Together in Health (PPO I-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Together in Health (PPO I-SNP) covers primary care, occupational therapy, and physical or speech therapy with no copay and no coinsurance, while chiropractic services are not covered. Specialist care, telehealth, mental health, psychiatry, and podiatry services are covered with no copay and a 20% coinsurance.
Preventive Services See details
Humana Together in Health (PPO I-SNP) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. However, this benefit is only partially covered, as additional services such as health education, fitness benefits, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are covered by Humana Together in Health (PPO I-SNP) with no deductible, offering fitting evaluations and unlimited OTC hearing aids for no copay and no coinsurance. Routine hearing exams are covered once annually with no copay and a 20% coinsurance, while prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $599 for up to two aids every three years (inner ear, outer ear, and over the ear types are not covered).
Vision Services See details
Vision services are covered by Humana Together in Health (PPO I-SNP) with no deductibles, offering one routine eye exam yearly with no copay and 20% coinsurance up to a $40 maximum. Eyewear is also covered with no copay and no coinsurance up to a $550 annual limit for one pair of contact lenses or eyeglasses (lenses and frames), while other eye exams, individual lenses or frames, and upgrades are not covered.
Dental Services See details
Humana Together in Health (PPO I-SNP) partially covers dental services with up to a $2,000 annual maximum benefit, offering most preventive and comprehensive services with no copay and no coinsurance, while Medicare-covered dental services require a 20% coinsurance and no copay. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Together in Health (PPO I-SNP) covers home infusion bundled services with prior authorization and step therapy. Covered Medicare Part B chemotherapy, insulin, and other drugs incur coinsurance ranging from no coinsurance up to 20%, with insulin requiring a $35 copay and other Part B drugs having no copay.
Dialysis Services See details
Dialysis Services are covered by Humana Together in Health (PPO I-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Together in Health (PPO I-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these medical equipment benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Together in Health (PPO I-SNP) covers diagnostic and radiological services, which require prior authorization and carry a 20% coinsurance. Members pay no copay for lab services, diagnostic tests, and outpatient X-rays, though diagnostic radiological services may require a copayment.
Home Health Services See details
Humana Together in Health (PPO I-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 not covered under the Humana Together in Health (PPO I-SNP) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD services are all not covered.
Skilled Nursing Facility (SNF) See details
Humana Together in Health (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance. Prior authorization and a prior three-day inpatient hospital stay are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Together in Health (PPO I-SNP) provides partial coverage for other services, offering acupuncture with no copay and 20% coinsurance, and over-the-counter items with no copay and no coinsurance. Meal benefits and other miscellaneous services are not covered.
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