A non-government entity
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 Arkansas. 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 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 $9800.00 (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 $9800.00 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 - Diabetes and Heart (PPO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan features an annual prescription drug deductible of $615.00 before the initial coverage phase begins. Once the deductible is met, copays for generic drugs range from $9.00 for preferred generics to $47.00 for standard generics. Brand-name and non-preferred drugs require coinsurance of 47% and 25% respectively, while specialty tier drugs have no copay. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs. Additionally, individuals who qualify for the low-income subsidy (LIS) can benefit from reduced premiums and a $0.00 Part D cost. This structured plan offers clear cost-sharing tiers to help you manage your prescription medication expenses effectively.
Additional Benefits
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan offers comprehensive medical coverage featuring no copay or coinsurance for primary care physician visits, routine preventive services, and home health care. Specialist visits, physical therapy, and outpatient mental health services are also highly accessible, requiring copays ranging from $15 to $35 with no coinsurance. For inpatient hospital stays, members pay a $295 copay for days 1 through 6, with no copay for days 7 through 90. Additional benefits include routine dental, vision, and hearing care with no copay, including up to $1,250 annually for dental services and a $250 annual allowance for eyewear. Members also benefit from no copay for up to 36 annual one-way transportation trips to plan-approved locations and diabetic therapeutic shoes. Most durable medical equipment and dialysis services require a 20% coinsurance, while emergency room visits carry a $130 copay.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), requiring a $295 copay for days 1 through 6, no copay for days 7 through 90, and no coinsurance for acute and psychiatric stays. Non-Medicare-covered stays, upgrades, and additional days for psychiatric care are not covered under this plan.
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. Patients will pay a $0 to $250 copay for outpatient hospital services, a $295 copay per stay for observation services, and a $30 to $35 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers partial hospitalization benefits with a $35 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 36 annual one-way trips to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care has a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services each carry a $130 copay and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), featuring no copay and no coinsurance for primary care physician visits, while podiatry services are not covered. Other covered services under this benefit, including specialist visits, physical therapy, and mental health services, require copays ranging from $15 to $35 with no coinsurance.
Preventive Services See details
Preventive services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered; the plan covers a memory fitness benefit with no copay and no coinsurance, but does not cover health education, weight management, alternative therapies, or caregiver support.
Hearing Services See details
Hearing services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no deductible, offering routine exams, fitting evaluations, and OTC hearing aids with no copay or coinsurance. Medicare-covered exams require a $15 copay and no coinsurance, while prescription hearing aids are partially covered with a $399 to $999 copay and no coinsurance for up to two devices per year, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers vision services, offering routine eye exams with no copay and other exams with a $0 to $15 copay, both featuring no coinsurance. Contact lenses and complete eyeglasses are covered up to a $250 annual limit with no copay and no coinsurance, but separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) provides partially covered dental services with an annual maximum benefit of $1,250, featuring no copays and no coinsurance for covered preventive and comprehensive services like cleanings, exams, and restorative care. Medicare-covered dental services require a $15 copay and no coinsurance, while fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers home infusion bundled services with prior authorization, offering chemotherapy, radiation, and other Part B drugs with no copay and coinsurance ranging from no coinsurance to 20%. Medicare Part B insulin drugs are covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. Members will pay a 20% coinsurance and no copay for DME and diabetic supplies, a 20% coinsurance for prosthetics and medical supplies, and no copay for diabetic therapeutic shoes and inserts.
Diagnostic and Radiological Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers diagnostic and radiological services, requiring prior authorization for all services. Lab and outpatient X-ray services have no copay and no coinsurance, while other diagnostic procedures and radiological services carry copays ranging from $0 to $360 with no coinsurance, except for therapeutic radiology which requires a $40 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HumanaChoice - Diabetes and Heart (PPO C-SNP) plan, as none of the associated sub-services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), are covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers skilled nursing facility (SNF) services, as additional days beyond Medicare-covered care are not covered. For covered days, you will pay a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100, with no coinsurance.
Other Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) offers partially covered Other Services, featuring acupuncture for a $15 copay and no coinsurance, alongside over-the-counter items and meal benefits with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit, and prior authorization is required for acupuncture and meal services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved