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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 2025, 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 2025.
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 $0.00. 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 $460.00 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 $14000.00 (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 $14000.00 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 Humana Together in Health (PPO I-SNP)
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Drug Coverage
The Humana Together in Health (PPO I-SNP) plan has a $460 deductible for prescription drugs. After the deductible, you will pay different costs depending on the drug tier and pharmacy. For Tier 1 preferred generic drugs, you will have no copay at standard and preferred mail pharmacies and a $0 copay at standard pharmacies. For all other tiers, you will pay 25% coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers a range of benefits with varying cost-sharing structures. The plan has no copay for primary care, preventive services, home health services, skilled nursing facility days 1-100, and routine hearing exams. Many services, including outpatient, partial hospitalization, ambulance, vision, dental, medical equipment, diagnostic, and dialysis services, have a coinsurance requirement, typically 20%. The plan covers inpatient hospital stays with a copay for acute care, and no copay after the first four days. It includes coverage for hearing aids, with copays for prescription hearing aids and a benefit for over-the-counter hearing aids. The plan also provides transportation services with no copay for a limited number of trips, and covers emergency and urgent care services with a copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric services. For Inpatient Hospital-Acute, you pay a $598 copay for days 1-4, and no copay for days 5-90, with no coinsurance. Inpatient Hospital Psychiatric has a $1872 copay, with no coinsurance.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services, each with a 20% coinsurance, and Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services, each with a coinsurance of 20%. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Together in Health (PPO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
The Humana Together in Health (PPO I-SNP) plan covers ambulance services with a 20% coinsurance for both ground and air ambulance services, and it covers transportation services with no copay, including 36 one-way trips to plan-approved health-related locations per year. Transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Humana Together in Health (PPO I-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a 20% coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $110 copay.
Primary Care See details
The Humana Together in Health (PPO I-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, specialist services, mental health, podiatry, other health care professional, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, occupational therapy, physical therapy and speech-language pathology services, and additional telehealth benefits have no copay, and specialist services, mental health, podiatry, other health care professional, psychiatric services, additional telehealth benefits, and opioid treatment program services have a 20% coinsurance. Chiropractic services do not cover routine care.
Preventive Services See details
Preventive Services includes coverage for an annual physical exam with no copay, and other preventive services are covered with no copay. Additional preventive services such as health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay and a 20% coinsurance, while fitting/evaluation for hearing aids has no copay and no coinsurance. Prescription hearing aids have a copay between $99 and $699 depending on the type of hearing aid, and OTC hearing aids have a maximum benefit of $75 every three months.
Vision Services See details
Vision services include eye exams, contact lenses, and eyeglasses with no copay and 20% coinsurance for eye exams, and are subject to a yearly maximum of $350. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered under the Humana Together in Health (PPO I-SNP) plan, with a 20% coinsurance for Medicare Dental Services and an annual maximum of $2,000 for other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay, and the number of visits and periodicity vary depending on the service. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Humana Together in Health (PPO I-SNP) plan and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Other Medicare Part B Drugs have no copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Together in Health (PPO I-SNP) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetic Devices with a 20% coinsurance, and Medical Supplies with a 20% coinsurance. Diabetic Supplies have a 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts have no copay. However, Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Together in Health (PPO I-SNP). Diagnostic Procedures/Tests and Radiological Services have a coinsurance of at most 20%, while Lab Services have a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by the Humana Together in Health (PPO I-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Humana Together in Health (PPO I-SNP) plan. The plan does not cover intensive cardiac rehabilitation services, pulmonary rehabilitation services, or SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Together in Health (PPO I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services", acupuncture is covered with a 20% coinsurance and requires prior authorization, but is limited to 20 treatments per year. Over-the-counter (OTC) items are also covered, with a maximum benefit of $75 every three months, and the plan offers Nicotine Replacement Therapy (NRT) and Naloxone coverage as a Part C OTC benefit, and any unused amount carries forward to the next period. Meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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