A non-government entity
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 2026, 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 WA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 $0.70. 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 $13900.00 (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 $13900.00 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:
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Drug Coverage
The Humana Together in Health (PPO I-SNP) Medicare plan features an annual prescription drug deductible of $615. This means you will pay the full cost of your covered medications up to this amount before the plan begins to pay its share. Specific details regarding drug tiers, copayments, and coinsurance are currently unavailable for this plan. To determine your actual out-of-pocket costs for specific medications, you will need to consult the plan's formulary directly. Understanding these deductible requirements is an essential step in choosing the right Medicare drug coverage for your budget. Knowing these details helps ensure you avoid unexpected expenses at the pharmacy.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers robust coverage for essential medical needs, featuring no copays or coinsurance for primary care visits, therapy services, and home health care. For inpatient hospital stays, members pay a $611 daily copay for the first four days and no copay thereafter, while most outpatient procedures, specialist visits, and medical equipment require a 20% coinsurance with no copay. Emergency room visits are covered with a $115 copay, which is waived if you are admitted to the hospital. This plan also provides valuable supplemental benefits, including preventive and comprehensive dental care up to a $1,000 annual limit with no copays or coinsurance. Vision and hearing services are covered with no copays, featuring up to $250 for annual eyewear and low-cost options for hearing aids. Additionally, skilled nursing facility stays are fully covered with no copay or coinsurance for the first 100 days, and members can access over-the-counter items at no cost.
Inpatient Hospital See details
Humana Together in Health (PPO I-SNP) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, there is a $611 daily copay for days 1 through 4 and no copay for days 5 and beyond, while psychiatric stays require a $1,872 copay per stay. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Together in Health (PPO I-SNP) covers outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services with no copay and a 20% coinsurance. Outpatient blood services are covered with no copay and no coinsurance, and prior authorization is required for most of these services.
Partial Hospitalization See details
Humana Together in Health (PPO I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Humana Together in Health (PPO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. While transportation services are technically covered, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Humana Together in Health (PPO I-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a 20% coinsurance (up to $40 per visit) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Together in Health (PPO I-SNP) covers primary care, occupational therapy, physical therapy, and speech-language services with no copay and no coinsurance. Specialist, mental health, psychiatric, podiatry, and telehealth services are covered with no copay and a 20% coinsurance, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Humana Together in Health (PPO I-SNP) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training with no copay and no coinsurance. However, these services are only partially covered, as additional benefits like fitness programs, health education, and nutritional therapy are not covered.
Hearing Services See details
Hearing services covered by Humana Together in Health (PPO I-SNP) include routine hearing exams with a 20% coinsurance and no copay, alongside OTC hearing aids with no copay and no coinsurance. Fitting and evaluation exams feature no copay and no coinsurance, while prescription hearing aids are partially covered with a $0 to $599 copay and no coinsurance, excluding inner ear, outer ear, and over-the-ear types.
Vision Services See details
Humana Together in Health (PPO I-SNP) partially covers vision services with no deductibles, featuring one routine eye exam per year with no copay and 20% coinsurance up to a $75 limit. Covered eyewear, including one pair of contact lenses or eyeglasses (lenses and frames) per year, has no copay and no coinsurance up to a $250 annual limit, while other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Together in Health (PPO I-SNP) partially covers dental services up to a $1,000 annual limit with no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require a 20% coinsurance and no copay. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Together in Health (PPO I-SNP) covers home infusion bundled services with prior authorization and step therapy. Covered insulin requires a $35 copay and 0% to 20% coinsurance, other Part B drugs have no copay and 0% to 20% coinsurance, and chemotherapy drugs require a copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Together in Health (PPO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered under the Humana Together in Health (PPO I-SNP) plan, including durable medical equipment, prosthetics, and diabetic supplies. These covered services require prior authorization and feature no copay alongside a 20% coinsurance.
Diagnostic and Radiological Services See details
Humana Together in Health (PPO I-SNP) covers diagnostic and radiological services with a 20% coinsurance, though prior authorization is required. There is no copay for lab services, diagnostic tests, therapeutic radiology, and outpatient X-rays, but diagnostic radiological services require a copay in addition to the 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Together in Health (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Together in Health (PPO I-SNP) covers some cardiac rehabilitation services with prior authorization required, although cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered. If services are obtained, cardiac and intensive cardiac rehabilitation require a 20% coinsurance and no copay, while pulmonary rehabilitation requires a $15 copay and no coinsurance, and SET for PAD requires a $20 copay and no coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Humana Together in Health (PPO I-SNP) with no copay and no coinsurance for days 1 through 100, though prior authorization and a three-day inpatient hospital stay are required. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Together in Health (PPO I-SNP) partially covers other services, which includes acupuncture with no copay and 20% coinsurance for up to 20 treatments annually, and over-the-counter items with no copay and no coinsurance. Meal benefits are not covered.
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