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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 Select Counties in TX. 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:
Sign up for Humana Together in Health (PPO I-SNP)
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Drug Coverage
The Humana Together in Health (PPO I-SNP) plan has a $500 deductible for prescription drugs. During the initial coverage phase, you will pay coinsurance for your prescriptions, such as 25% for standard generic drugs and 27% for preferred brand drugs, depending on the pharmacy you use. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you may pay $0 for your Part D drugs.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have coinsurance. Primary care, preventive services, vision, dental, and home health services have no copays. The plan includes coverage for hearing services, with copays for hearing aids, and covers ambulance, emergency, and transportation services with coinsurance or copays. Other benefits include medical equipment, diagnostic services, and dialysis services with coinsurance. The plan also offers an over-the-counter benefit up to $75 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered under the Humana Together in Health (PPO I-SNP) plan. For Inpatient Hospital-Acute, you will pay a copay of $598 for days 1-4 and no copay for days 5-90. For Inpatient Hospital Psychiatric, the copay is $1872. Additional days for Inpatient Hospital-Acute are covered with no copay, while non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services and Observation Services have a 20% coinsurance, while Ambulatory Surgical Center Services and Outpatient Substance Abuse Services have a coinsurance between 20% and 20%. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Together in Health (PPO I-SNP) plan, but requires prior authorization, with a 20% coinsurance.
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, and Transportation Services to a plan-approved health-related location have no copay for up to 36 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services has a 20% coinsurance.
Primary Care See details
The Humana Together in Health (PPO I-SNP) plan covers primary care physician services and chiropractic services with no copay. Occupational therapy services, physical therapy, and speech-language pathology services have no copay and no coinsurance. Physician specialist services, mental health specialty services, podiatry services, other health care professional, psychiatric services, and additional telehealth benefits all have a 20% coinsurance.
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 services like health education, in-home safety assessments, and more are not covered.
Hearing Services See details
Hearing Services are covered by Humana Together in Health (PPO I-SNP), including hearing exams and prescription hearing aids with varying cost sharing. Routine hearing exams have no copay and 20% coinsurance, and fitting/evaluation for hearing aids have no copay and no coinsurance. Prescription hearing aids (all types) have a copay between $99 and $699, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are covered up to $75 every three months.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay and 20% coinsurance, while eyewear has no copay. Contact lenses and eyeglasses (lenses and frames) are covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Together in Health (PPO I-SNP) plan covers Medicare Dental Services with 20% coinsurance, and other dental services up to a $2,000 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, and Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%, and no copay.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Humana Together in Health (PPO I-SNP) plan. Diagnostic Procedures/Tests and Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay and a coinsurance of at most 20%.
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. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Together in Health (PPO I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, which has a 20% coinsurance and requires prior authorization, and Over-the-Counter (OTC) Items, which are covered as a supplemental Part C benefit with a maximum coverage amount of $75.00 every three months. Meal Benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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