HumanaChoice H5216-387 (PPO)

HumanaChoice H5216-387 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Maryland. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice H5216-387 (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about HumanaChoice H5216-387 (PPO).

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.

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:

Drug Coverage

The HumanaChoice H5216-387 (PPO) prescription drug plan features an annual drug deductible of $500. For Tier 1 preferred generic drugs, beneficiaries pay no copay at standard pharmacies or through preferred mail order, though standard mail order carries a $10 copay for one month or $30 copay for three months. Tier 2 generic medications also offer a $0 copay for a three-month supply via preferred mail order, or a low $5 copay for a one-month supply at standard pharmacies and preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, with three-month supplies costing $131 through preferred mail order and $141 through standard pharmacies or standard mail order. Tier 4 non-preferred drugs require a 50% coinsurance across all pharmacy options, while Tier 5 specialty drugs require a 27% coinsurance for a one-month supply. This structured plan helps you navigate your healthcare budget by offering clear pricing across different tiers and pharmacy choices.

Additional Benefits

The HumanaChoice H5216-387 (PPO) plan provides comprehensive medical coverage featuring no copays for primary care visits, preventive services, home health care, and laboratory work. For specialized care, members can expect a $40 copay for specialist visits, a $115 copay for emergency room services, and daily copays for inpatient hospital stays starting at $340 for the first several days before transitioning to no copay. Outpatient services and surgeries generally require no coinsurance, though individual copays vary depending on the specific service. Supplemental benefits under this plan include routine vision and preventive dental care with no copay, alongside a $1,000 annual allowance for dental services. Prescription hearing aids are covered with copays ranging from $699 to $999, while durable medical equipment and dialysis services require a 20% coinsurance with no copay. This plan also covers skilled nursing facility stays, offering no copay for the first 20 days and a $218 daily copay for days 21 through 100.