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Humana Dual Select H5619-126 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Select H5619-126 (HMO-POS 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 H5619-126 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Humana Dual Select H5619-126 (HMO-POS D-SNP) is a HMO-POS D-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 2025.
It's important to know that Humana Dual Select H5619-126 (HMO-POS 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 H5619-126 (HMO-POS 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 H5619-126 (HMO-POS 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 H5619-126 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $24.10. 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 Maximum Out-Of-Pocket cost of $8850.00 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 H5619-126 (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs based on the tier of the drug. The plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you qualify for LIS, you will pay $24.10 for Part D. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Humana Dual Select H5619-126 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, but outpatient services have a mix of copays and coinsurance. Emergency services have a copay, and ambulance services have a copay. The plan covers primary care visits with no copay, and specialist visits have a copay. Preventive services are covered with no copay, and vision and dental services are covered with copays. Hearing services have a copay for exams, and home health services have no cost.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric care, with a copay of $350 for days 1-5 and no copay for days 6-90; additional days for inpatient hospital acute have no copay. Non-Medicare-covered stays and upgrades for inpatient hospital acute, as well as additional days and non-Medicare-covered stays for inpatient hospital psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $350 copay and 20% coinsurance, Observation Services with a $350 copay, Ambulatory Surgical Center (ASC) Services with a $300 copay and 20% coinsurance, and Outpatient Substance Abuse Services with a $30 copay and 20% coinsurance. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan, with a $315 copay for both ground and air ambulance services and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered under the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay with no coinsurance, while Urgently Needed Services have a 20% coinsurance with no copay. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $110 copay.
Primary Care See details
Primary Care benefits include no copay for Primary Care Physician Services and Chiropractic Services, a $30 copay for Physician Specialist Services, and a copay of $30 for both Individual and Group Sessions for Mental Health and Psychiatric Services. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services have a 20% coinsurance, while Additional Telehealth Benefits have a 20% coinsurance and a copay between $0 and $30. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services are covered by Humana Dual Select H5619-126 (HMO-POS D-SNP), including an annual physical exam with no copay. Other covered services include wigs for hair loss, additional sessions of smoking and tobacco cessation counseling, fitness benefits, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay.
Hearing Services See details
Hearing Services are partially covered by the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan. Hearing exams have a $30 copay, while routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids (all types, inner ear, outer ear, and over the ear), and OTC hearing aids are not covered.
Vision Services See details
The Humana Dual Select H5619-126 (HMO-POS D-SNP) plan covers vision services, including routine eye exams with a copay of $0-$30, and eyewear with a maximum plan benefit of $250 per year and no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $30 copay, Oral Exams with no copay, Dental X-Rays with no copay, Other Diagnostic Dental Services with no copay, Prophylaxis (Cleaning) with no copay, Other Preventive Dental Services with no copay, Restorative Services with no copay, Adjunctive General Services with no copay, Endodontics with no copay, Periodontics with no copay, Prosthodontics (removable) with no copay, Implant Services with no copay, Prosthodontics (fixed) with no copay, and Oral and Maxillofacial Surgery with no copay, while Fluoride Treatment and Maxillofacial Prosthetics are not covered, and there is a $2,500 maximum plan benefit per year. Orthodontic Services are covered under Diagnostic and Preventive Dental.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Insulin has a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%, with no copay.
Dialysis Services See details
Dialysis Services are covered under the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan. This plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, and Medical Supplies, is covered. DME has a 20% coinsurance, and no copay, while Medical Supplies and Prosthetic Devices have a 20% coinsurance and no copay. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a copay of up to $30 and a coinsurance of at least 20%, while Lab Services and Outpatient X-Ray Services have no copay and a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Humana Dual Select H5619-126 (HMO-POS D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond those covered by Medicare, and non-Medicare-covered stays, are not covered.
Other Services See details
The Humana Dual Select H5619-126 (HMO-POS D-SNP) plan covers acupuncture with a $30 copay per visit, up to 20 treatments per year, and also includes an over-the-counter (OTC) items benefit with a $1200 maximum per year. The plan also covers a meal benefit with no copay. However, 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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