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 West Virginia. 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 $12.90. 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 must pay this amount out-of-pocket for your covered medications before the plan begins to pay its share. Specific drug coverage tier details, including copayments and coinsurance rates for individual formulary tiers, are not available for this plan. To understand your exact medication costs, you should verify how your specific prescriptions are covered under this plan's formulary.
Additional Benefits
The Humana Together in Health (PPO I-SNP) plan offers comprehensive medical coverage with no copays or coinsurance for primary care, physical therapy, home health services, and up to 100 days of skilled nursing facility care. For inpatient acute hospital stays, members pay a daily copay of $611 for the first four days and no copay for subsequent days, while emergency room visits carry a $115 copay that is waived if admitted. Most outpatient services, specialist visits, diagnostic tests, and durable medical equipment require a 20% coinsurance with no copay. For everyday wellness, the plan features preventive and comprehensive dental care with no copay or coinsurance up to a $1,000 annual limit, alongside routine vision and hearing benefits with no deductibles. Routine eye and hearing exams generally require a 20% coinsurance and no copay, while over-the-counter hearing aids and other select over-the-counter items are available with no copay or coinsurance. Additionally, key preventive services and annual physical exams are covered with no copay and no coinsurance.
Inpatient Hospital See details
Humana Together in Health (PPO I-SNP) covers inpatient hospital services with no coinsurance, requiring prior authorization for both acute and psychiatric stays. Acute stays incur a $611 copay per day for days 1 to 4 with no copay for subsequent days, while psychiatric stays require a $1,872 copay per admission; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Together in Health (PPO I-SNP) covers outpatient services with no copays, though a 20% coinsurance and prior authorization apply to outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
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 this covered benefit.
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. Transportation services are not covered under this plan.
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 require a 20% coinsurance (up to $40) 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) offers primary care, physical therapy, occupational therapy, and speech therapy services with no copay and no coinsurance. Specialist visits, mental health, psychiatric, podiatry, and opioid treatment services also feature no copay but require a 20% coinsurance, while chiropractic services are not covered.
Preventive Services See details
Humana Together in Health (PPO I-SNP) covers preventive services, including annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and EKGs, with no copay and no coinsurance. However, additional preventive services like fitness benefits, health education, in-home safety assessments, and nutritional/dietary benefits are not covered.
Hearing Services See details
Humana Together in Health (PPO I-SNP) provides hearing services with no deductible, including routine exams for a 20% coinsurance and no copay, and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $599, though inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision Services are partially covered under Humana Together in Health (PPO I-SNP) with no deductibles, featuring routine eye exams with no copay and 20% coinsurance, and eyewear with no copay and no coinsurance. Other eye exam services, standalone eyeglass lenses, standalone eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Together in Health (PPO I-SNP) provides partially covered dental services with no copay and no coinsurance for preventive and comprehensive care, up to a $1,000 annual limit for both in- and out-of-network services, while Medicare-covered dental requires a 20% coinsurance and no copay. Specific exclusions apply, as 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, subject to prior authorization and step therapy. Covered Medicare Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance, other Part B drugs have no copay and no coinsurance to 20% coinsurance, and chemotherapy or radiation drugs require a copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Humana Together in Health (PPO I-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Humana Together in Health (PPO I-SNP) with no copay and 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic supplies. Prior authorization is required for these benefits, and diabetic equipment and supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Together in Health (PPO I-SNP) with prior authorization and a 20% coinsurance. There is no copay for lab services, diagnostic procedures, and outpatient X-rays, though diagnostic radiological services are subject to a copayment.
Home Health Services See details
Humana Together in Health (PPO I-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Together in Health (PPO I-SNP) requires prior authorization for cardiac rehabilitation, and while some services are covered, several key programs are not. Specifically, cardiac rehabilitation (20% coinsurance), intensive cardiac rehabilitation (20% coinsurance), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for PAD ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Humana Together in Health (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance. Prior authorization and a three-day inpatient hospital stay prior to admission are required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Together in Health (PPO I-SNP), which offers acupuncture with no copay and 20% coinsurance up to 20 treatments per year, as well as over-the-counter items with no copay and no coinsurance. Meal benefits are not covered under this plan.
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