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 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 New Mexico. 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 $590.00 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:
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Drug Coverage
The Humana Together in Health (PPO I-SNP) plan has a $590.00 deductible for prescription drugs. During the initial coverage phase, after you meet your deductible, you pay coinsurance for your prescriptions. The coinsurance rates vary by drug tier and pharmacy type. For example, standard generic drugs have a 25% coinsurance, while preferred brand drugs have a 26% coinsurance.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers a range of benefits with varying cost-sharing. The plan covers inpatient hospital stays with a copay of $598 for days 1-4 and no copay for days 5-90, and outpatient services, including primary care, with no copay. Many services such as hearing and vision exams, and dental services are covered with no copay. Additional coverage includes ambulance and transportation services, emergency services, and preventive services, often with a coinsurance or no copay. The plan also provides coverage for home health services, skilled nursing facilities, and durable medical equipment. However, services like cardiac rehabilitation and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Humana Together in Health (PPO I-SNP) plan, including Inpatient Hospital-Acute with a copay of $598 for days 1-4 and no copay for days 5-90, and Additional Days for Inpatient Hospital-Acute with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Inpatient Hospital Psychiatric has a copay of $1872.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient substance abuse services, are covered. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services have 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
Ambulance and Transportation Services include coverage for ground and air ambulance services with a 20% coinsurance, as well as transportation services to plan-approved health-related locations with no copay and up to 36 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a 20% coinsurance.
Primary Care See details
The Humana Together in Health (PPO I-SNP) plan offers primary care services with no copay, chiropractic services with no copay, and occupational therapy services with no coinsurance and no copay. Physician specialist services and additional telehealth benefits have a 20% coinsurance, and mental health and psychiatric services have a 20% coinsurance. Physical therapy and speech-language pathology services have no copay and no coinsurance, while other health care professional services have a 20% coinsurance and no copay. Podiatry services and Opioid Treatment Program Services have a 20% coinsurance.
Preventive Services See details
The Humana Together in Health (PPO I-SNP) plan covers preventive services, including an annual physical exam with no copay. Kidney disease education services and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit are covered with no copay. However, additional preventive services like health education, in-home safety assessment, and others are not covered.
Hearing Services See details
Hearing Services are covered, including hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids. Routine hearing exams have no copay, and a 20% coinsurance. Fitting/evaluation for hearing aids have no copay and no coinsurance. Prescription hearing aids (all types) have a copay between $99 and $699, depending on the type of hearing aid. OTC hearing aids are covered up to $75 every three months.
Vision Services See details
Vision services include coverage for eye exams with no copay and 20% coinsurance. Eyewear is covered with no copay, and contact lenses and eyeglasses have a combined maximum of $350 every year.
Dental Services See details
The Humana Together in Health (PPO I-SNP) plan covers dental services with a 20% coinsurance for Medicare dental services, and a maximum benefit of $2,000 per year 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. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Together in Health (PPO I-SNP) plan, but require prior authorization. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment, with Diabetic Supplies having a 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered, including diagnostic procedures and tests with a coinsurance of at most 20%, and lab services with no copay and a coinsurance of at most 20%. Radiological services are also covered, with diagnostic and therapeutic radiological services and outpatient X-ray services having a coinsurance of at most 20%, and outpatient X-ray services having 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. 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. This plan does not cover any of the sub-services for Cardiac Rehabilitation Services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Humana Together in Health (PPO I-SNP) plan with prior authorization required. For days 1-100, there is no copay. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, which has a 20% coinsurance and requires prior authorization, and over-the-counter (OTC) items, with a maximum coverage amount of $75 every three months. 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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