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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 Oklahoma. 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 $9700.00 (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 $9700.00 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)
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Drug Coverage
The HumanaChoice - Diabetes and Heart (PPO C-SNP) prescription drug plan features an annual drug deductible of $615. You will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs at standard pharmacies and through preferred mail order. Generic drugs in Tier 2 are also highly accessible, with a $9 copay for a one-month supply at standard pharmacies and no copay for a three-month supply filled via preferred mail order. For brand-name and specialty medications, Tier 3 preferred brands require a $47 copay for a one-month supply. Higher-tier prescriptions involve coinsurance rather than flat copays, with Tier 4 non-preferred drugs requiring a 47% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance.
Additional Benefits
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan offers robust medical coverage with no copay for primary care visits, preventive care, home health services, and cardiac rehabilitation. Specialist visits, physical therapy, and diagnostic exams are highly accessible, typically requiring a low $25 copay. For inpatient hospital stays, members pay a $300 daily copay for the first six days, followed by no copay for days seven through ninety. In addition to medical care, the plan provides generous supplemental benefits, including no copay for routine vision exams, eyewear up to $250, and most preventive and comprehensive dental care up to a $1,500 annual limit. Routine hearing exams and over-the-counter hearing aids also feature no copay, while prescription hearing aids require copays between $199 and $799. Members also benefit from no copay on over-the-counter items and chronic illness meal benefits.
Inpatient Hospital See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copays. Outpatient hospital services require a copay of $0 to $270 (or $300 per stay for observation services), and outpatient substance abuse sessions have a copay of $30 to $35.
Partial Hospitalization See details
Partial hospitalization services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with a $35.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Medicare-approved ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. While transportation services are technically listed as covered, transportation to plan-approved or any health-related locations is not covered in practice.
Emergency Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay with no coinsurance, and worldwide emergency, urgent, and transportation services are available for a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) offers primary care physician services with no copay and no coinsurance, and specialist, physical therapy, and occupational therapy visits with a $25 copay and no coinsurance. Mental health and psychiatric services require a $30 copay with no coinsurance, podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
Preventive services are covered under the HumanaChoice - Diabetes and Heart (PPO C-SNP) plan with no copays and no coinsurance for annual physical exams, kidney disease education, and diabetes self-management training. This benefit is partially covered, as supplemental services like health education, nutritional counseling, and weight management are not covered, though a memory fitness program is included with no copay.
Hearing Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers hearing exams with a $25 copay and no coinsurance, while routine annual exams, fittings, and OTC hearing aids feature no copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $199 to $799 and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) provides partially covered vision services with no coinsurance and no deductibles, featuring no copay for one routine eye exam (up to $75) and one yearly pair of eyeglasses or contact lenses (up to $250). Other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers dental services up to a $1,500 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive services, while Medicare-covered dental services require a $25 copay and no coinsurance. Fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and removable prosthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, feature a coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers medical equipment, prosthetics, and diabetic supplies with a 20% coinsurance and no copay. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers diagnostic services with no coinsurance, offering $0 copay lab services and diagnostic tests ranging from a $0 to $100 copay. Covered radiological services require prior authorization and include outpatient X-rays and diagnostic radiology starting at no copay, alongside therapeutic radiology which carries a minimum $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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, no prior three-day inpatient hospital stay is needed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services under the HumanaChoice - Diabetes and Heart (PPO C-SNP) are partially covered, featuring acupuncture for a $25 copay and no coinsurance (up to 20 treatments per year), alongside over-the-counter items and chronic illness meal benefits for no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, while other additional services under this category are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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* 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.
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