HumanaChoice Florida SNP-DE H5216-394 (PPO D-SNP)

HumanaChoice Florida SNP-DE H5216-394 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Central and North Florida. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice Florida SNP-DE H5216-394 (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 Florida SNP-DE H5216-394 (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 Florida SNP-DE H5216-394 (PPO D-SNP) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when using standard pharmacies or preferred mail order for 1-month and 3-month supplies. If you opt for standard mail order instead, Tier 1 drugs require a $10 copay for 1 month ($30 for 3 months), and Tier 2 drugs require a $20 copay for 1 month ($60 for 3 months). For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a flat 25% coinsurance. This 25% coinsurance applies to standard pharmacies as well as preferred and standard mail order options. Knowing these tier structures and fulfillment choices can help you minimize your out-of-pocket prescription costs under this plan.

Additional Benefits

The HumanaChoice Florida SNP-DE H5216-394 (PPO D-SNP) offers comprehensive medical coverage with no copays or coinsurance for primary care, specialist visits, preventive care, and home health services. For inpatient hospital stays, members pay a $1,000 copay per stay with no coinsurance, while outpatient hospital services generally range from no copay to a $35 copay along with a 20% coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features valuable supplemental benefits, including routine dental, vision, and hearing care with no copays or coinsurance up to specified plan limits. Members can also access unlimited one-way transportation to plan-approved locations, over-the-counter items, and chronic illness meals with no copays. Additionally, diagnostic services, dialysis, and durable medical equipment are covered with a 20% coinsurance and no copay.