HumanaChoice SNP-DE H5216-388 (PPO D-SNP)

HumanaChoice SNP-DE H5216-388 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Michigan (Non-Detroit). This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice SNP-DE H5216-388 (PPO D-SNP) 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 SNP-DE H5216-388 (PPO D-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.

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 SNP-DE H5216-388 (PPO D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using a standard pharmacy or preferred mail-order service for 1-month or 3-month supplies. However, utilizing standard mail order for these lower-tier drugs results in copays ranging from $10 to $20 for a 1-month supply. For higher-tier medications, including Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate remains the same whether you fill your prescription at a standard pharmacy, through preferred mail order, or via standard mail order.

Additional Benefits

The HumanaChoice SNP-DE H5216-388 (PPO D-SNP) offers comprehensive medical coverage, featuring no copays and a 20% coinsurance for primary care, specialist visits, outpatient hospital services, and durable medical equipment. For inpatient hospital stays, members pay a set copay of $2,230 per acute stay and $2,080 per psychiatric stay with no coinsurance. Emergency care is covered with a $115 copay, which is waived if you are admitted, while routine home health and preventive services are available with no copays or coinsurance. Ancillary benefits include partially covered routine dental, vision, and hearing services, which generally feature no copays but may require a 20% coinsurance. Skilled nursing facility care is covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. Additionally, the plan covers essential daily needs like over-the-counter items and chronic illness meals with no copays or coinsurance.