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Humana Dual Select H5619-075 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Select H5619-075 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Dual Select H5619-075 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Dual Select H5619-075 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Kentucky. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Dual Select H5619-075 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Dual Select H5619-075 (HMO D-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 Dual Select H5619-075 (HMO 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.
For Humana Dual Select H5619-075 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $7.80. 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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 Dual Select H5619-075 (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using standard pharmacies or preferred mail order services for one-month and three-month supplies. If you choose standard mail order instead, a copay of $10 to $20 applies for a one-month supply. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% coinsurance applies to standard pharmacies, preferred mail order, and standard mail order options. This structure ensures straightforward, predictable cost-sharing for your brand-name and specialty medication needs.
Additional Benefits
The Humana Dual Select H5619-075 (HMO D-SNP) offers comprehensive healthcare coverage with no copay for primary care visits, annual physicals, and home health services. Specialist visits, mental health sessions, and Medicare-covered dental and hearing exams require a low $30 copay, while inpatient hospital stays incur a copay of $595 for the first four days. Outpatient hospital services range from no copay up to a $595 copay with a 20% coinsurance, while emergency room visits carry a $115 copay that is waived upon hospital admission. This plan also includes valuable supplemental benefits, such as routine dental and vision care, both featuring no copayments alongside annual coverage limits of $1,000 for dental and $250 for eyewear. Additionally, members can access up to 24 free one-way transportation trips per year and routine hearing exams with no copay. Durable medical equipment, dialysis, and diagnostic services generally require a 20% coinsurance, while skilled nursing facility stays have no copay for the first 20 days.
Inpatient Hospital See details
Humana Dual Select H5619-075 (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $595 copay for days 1-4 of acute stays and a $675 copay for days 1-3 of psychiatric stays. There is no copay for subsequent days, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the Humana Dual Select H5619-075 (HMO D-SNP) are covered, featuring no copay and no coinsurance for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a $0 to $595 copay and 20% coinsurance, while outpatient substance abuse sessions have a $30 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Humana Dual Select H5619-075 (HMO D-SNP) plan with a $35.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Humana Dual Select H5619-075 (HMO D-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
Humana Dual Select H5619-075 (HMO D-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 are covered with a 20% coinsurance (up to $40 per visit) and no copay, while worldwide emergency, urgent, and transportation services require a $115 copay and no coinsurance.
Primary Care See details
Humana Dual Select H5619-075 (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, mental health, and psychiatric visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapies are covered with no copay and a 20% coinsurance, but podiatry is not covered, and chiropractic care covers some services while routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Humana Dual Select H5619-075 (HMO D-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, and select screenings. Additional preventive benefits are only partially covered; memory fitness, smoking cessation, and chemotherapy wigs are included, but health education, PERS, in-home safety assessments, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, remote access, home safety devices, and counseling are not covered.
Hearing Services See details
Humana Dual Select H5619-075 (HMO D-SNP) covers hearing exams with a $30 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fitting evaluations. OTC hearing aids are covered with no copay and no coinsurance, while prescription hearing aids are partially covered with no copay and no coinsurance, excluding inner ear, outer ear, and over the ear hearing aids.
Vision Services See details
Vision Services are partially covered under the Humana Dual Select H5619-075 (HMO D-SNP) plan, offering eye exams with a $0 to $30 copay and covered eyewear with no copay, both featuring no coinsurance and no deductible. While routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered up to a $250 annual limit with prior authorization, other eye exams, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Dual Select H5619-075 (HMO D-SNP) offers partially covered dental services, featuring a $30 copay and no coinsurance for Medicare-covered dental, and other covered preventive and comprehensive services with no copay or coinsurance up to a $1,000 annual maximum. Fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Dual Select H5619-075 (HMO D-SNP) covers Home Infusion bundled Services with prior authorization and step therapy requirements. Covered Part B drugs, including chemotherapy and insulin, incur no coinsurance to 20% coinsurance, with a $35 copay for insulin and no copay for other Part B drugs.
Dialysis Services See details
Dialysis Services are covered by Humana Dual Select H5619-075 (HMO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical Equipment is covered by Humana Dual Select H5619-075 (HMO D-SNP) with no copays, though a 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic supplies. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Dual Select H5619-075 (HMO D-SNP) covers diagnostic and radiological services, which require prior authorization and carry a 20% coinsurance. Outpatient diagnostic procedures and tests require a copay of up to $30, while lab services, diagnostic radiological services, and outpatient X-rays feature no copay.
Home Health Services See details
Home Health Services are covered by Humana Dual Select H5619-075 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Dual Select H5619-075 (HMO D-SNP) with no copay, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance along with prior authorization.
Skilled Nursing Facility (SNF) See details
Humana Dual Select H5619-075 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Dual Select H5619-075 (HMO D-SNP) covers acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year. Over-the-counter (OTC) items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for some services.
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