HumanaChoice SNP-DE H5216-459 (PPO D-SNP)

HumanaChoice SNP-DE H5216-459 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Maryland. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that HumanaChoice SNP-DE H5216-459 (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 SNP-DE H5216-459 (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 SNP-DE H5216-459 (PPO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no coinsurance for Tier 1 preferred generic drugs when using standard pharmacies or preferred mail order services. For Tier 2 generic medications, standard pharmacies charge a 5% coinsurance, while preferred mail order services offer a three-month supply with no coinsurance. For Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the cost-sharing is consistently a 25% coinsurance across standard pharmacies and mail order options. Standard mail order services for Tier 1 and Tier 2 drugs also require a 25% coinsurance. This plan provides a clear cost structure to help you manage your healthcare budget and prescription drug expenses.

Additional Benefits

The HumanaChoice SNP-DE H5216-459 (PPO D-SNP) plan offers comprehensive healthcare coverage with no copay and a 20% coinsurance for primary care visits. Inpatient hospital stays require a $2,230 copay per acute stay with no coinsurance, while emergency room services carry a $115 copay that is waived upon admission. Outpatient hospital services feature up to a $250 copay alongside a 20% coinsurance. Everyday care benefits include routine hearing and vision exams with no copay and 20% coinsurance, alongside dental coverage of up to $1,000 annually with no copay or coinsurance for covered non-Medicare services. The plan also covers up to 24 one-way transportation trips per year to plan-approved locations and provides home health services with no copay or coinsurance. Additionally, skilled nursing facility stays feature no copay for the first 20 days.