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 Select Counties in Texas. 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 $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 $610.00 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 $610. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay for both 1-month and 3-month supplies at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs carry a $10 copay for a 1-month supply and a $30 copay for a 3-month supply, while Tier 2 drugs cost $20 for 1-month and $60 for 3-month fills. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a flat 25% coinsurance. This 25% coinsurance applies across standard pharmacies, preferred mail order, and standard mail order options. Understanding these clear cost-sharing rates helps you easily estimate your prescription drug expenses once your deductible is met.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan provides comprehensive medical coverage with many essential services featuring no copay and no coinsurance, including primary care, home health services, and skilled nursing facility stays up to 100 days. For inpatient acute hospital stays, members pay a $611 daily copay for days one through four, while emergency room visits require a $115 copay. Most outpatient services, specialist visits, and durable medical equipment are covered with no copay and a 20% coinsurance. For supplemental care, the plan features dental benefits covering preventive and comprehensive services with no copay and no coinsurance up to a $1,000 annual maximum. Routine hearing and vision exams require no copay and a 20% coinsurance, alongside allowances of up to $250 for eyewear and various copay options for hearing aids. Members also benefit from covered over-the-counter items with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Together in Health (PPO I-SNP) with no coinsurance and prior authorization required, though non-Medicare-covered stays and upgrades are not covered. Acute stays require a $611 daily copay for days 1 through 4 and no copay for days 5 and beyond, while psychiatric care carries a $1,872 copay per stay.
Outpatient Services See details
Humana Together in Health (PPO I-SNP) covers outpatient services with no copay, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay and no coinsurance, with prior authorization required for most outpatient benefits.
Partial Hospitalization See details
Partial hospitalization services are covered by Humana Together in Health (PPO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
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. Transportation services to plan-approved or other 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 (no copay, maximum $40 per visit), and worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Primary care benefits under Humana Together in Health (PPO I-SNP) offer primary care, physical therapy, occupational therapy, and speech-language services with no copay and no coinsurance. Specialist visits, mental health, psychiatric, podiatry, and telehealth services are covered with no copay and a 20% coinsurance, though chiropractic services are not covered.
Preventive Services See details
Humana Together in Health (PPO I-SNP) offers partial coverage for preventive services, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance. However, additional benefits such as fitness programs, health education, and personal emergency response systems are not covered.
Hearing Services See details
Humana Together in Health (PPO I-SNP) provides partially covered hearing services, excluding inner ear, outer ear, and over-the-ear prescription hearing aids. Routine exams have no copay and 20% coinsurance, while fitting evaluations, OTC hearing aids, and covered prescription hearing aids have no coinsurance and copays ranging from no copay to $599.
Vision Services See details
Vision services are partially covered by Humana Together in Health (PPO I-SNP), featuring routine eye exams with no copay and 20% coinsurance up to a $75 annual limit, though other eye exam services are not covered. Eyewear is also partially covered with no copay and no coinsurance up to a $250 annual limit for contact lenses and eyeglasses, but individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Humana Together in Health (PPO I-SNP) partially covers dental services, offering no copay and no coinsurance for most preventive and comprehensive care up to a $1,000 annual maximum, 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, which require prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs have a $35 copay and 0% to 20% coinsurance, other Part B drugs have no copay and 0% to 20% coinsurance, and chemotherapy drugs require a copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Humana Together in Health (PPO I-SNP) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Together in Health (PPO I-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Together in Health (PPO I-SNP), with prior authorization required for all services. Members will pay a 20% coinsurance and no copay for lab services, diagnostic procedures, and outpatient X-rays, while other diagnostic and therapeutic radiological services require a 20% coinsurance and a copayment.
Home Health Services See details
Home Health Services are covered by Humana Together in Health (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Humana Together in Health (PPO I-SNP) require prior authorization; some services are covered, but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. Patients will pay a 20% coinsurance and no copay for Cardiac and Intensive Cardiac Rehabilitation, a $15 copay and no coinsurance for Pulmonary Rehabilitation, and a $20 copay and no coinsurance for SET for PAD.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Together in Health (PPO I-SNP) for days 1 through 100 with no copay and no coinsurance, though prior authorization and a three-day prior inpatient hospital stay are required. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Together in Health (PPO I-SNP) provides acupuncture coverage with no copay and a 20% coinsurance for up to 20 treatments per year, as well as over-the-counter items with no copay and no coinsurance. Meal benefits and other additional services are not covered.
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