A non-government entity
Humana Dual Select H5619-165 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Select H5619-165 (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 H5619-165 (HMO D-SNP) in 2025, please refer to our full plan details page.
Humana Dual Select H5619-165 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in WA. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Dual Select H5619-165 (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 H5619-165 (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 H5619-165 (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 H5619-165 (HMO 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 $9350.00 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:
Sign up for Humana Dual Select H5619-165 (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Dual Select H5619-165 (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, the plan covers drugs, and you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach that amount, you will enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly Part D premium will be $24.10. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Humana Dual Select H5619-165 (HMO D-SNP) plan offers a wide range of benefits, including inpatient and outpatient hospital services with varying copays and coinsurance, as well as coverage for emergency services. You'll find no copays for many services, such as primary care, preventive services, and home health. The plan also includes hearing, vision, and dental coverage, with copays and some limitations. Additional benefits include coverage for ambulance and transportation, partial hospitalization, and other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a $300 copay for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric services are covered with a $300 copay for days 1-6 and no copay for days 7-90, but additional days and Non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a $295 copay and 20% coinsurance, observation services with a $300 copay, ambulatory surgical center services with a $295 copay and 20% coinsurance, outpatient substance abuse services with 20% coinsurance for individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Dual Select H5619-165 (HMO D-SNP) plan, with an $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance, as well as transportation services to plan-approved health-related locations. Ground ambulance services have a $315 copay, while air ambulance services have 20% coinsurance; transportation services to plan-approved health-related locations have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under the Humana Dual Select H5619-165 (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay; all have no coinsurance.
Primary Care See details
The Humana Dual Select H5619-165 (HMO D-SNP) plan covers primary care physician services and chiropractic services with no copay, and also covers occupational therapy with a $35 copay. The plan covers physician specialist services with a $30 copay, mental health specialty services with 20% coinsurance, and physical therapy and speech-language pathology services with a $35 copay. Additionally, the plan offers additional telehealth benefits with 20% coinsurance and a copay between $0 and $45, and covers opioid treatment program services with 20% coinsurance.
Preventive Services See details
Preventive Services include no copay for Medicare-covered services, Annual Physical Exams, and Additional Sessions of Smoking and Tobacco Cessation Counseling. Other covered services include Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit, all with no copay.
Hearing Services See details
Hearing Services are covered, including hearing exams with a $30 copay, routine hearing exams with no copay for one exam every year, and fitting/evaluation for hearing aids with no copay. Prescription Hearing Aids are partially covered, as Prescription Hearing Aids (all types) have no copay for two hearing aids every three years, while Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
The Humana Dual Select H5619-165 (HMO D-SNP) plan covers vision services, including routine eye exams with a copay of $0-$30 and eyewear with a copay of $0, although eyeglass lenses, eyeglass frames, and upgrades are not covered. The plan also covers contact lenses and eyeglasses (lenses and frames) with a $0 copay.
Dental Services See details
Dental services include coverage for Medicare Dental Services with a $30 copay, and other dental services with a $1,000 annual maximum. 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. Insulin drugs have a $35 copay and a coinsurance between 0% and 20%. 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, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, Medical Supplies with 20% coinsurance, Diabetic Supplies with 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 by the Humana Dual Select H5619-165 (HMO D-SNP) plan. Diagnostic Procedures/Tests have a copay of up to $45 and coinsurance of at most 20%, Lab Services have no copay, Diagnostic Radiological Services have a copay of up to $350 and coinsurance of at most 20%, Therapeutic Radiological Services have coinsurance of at most 20%, and Outpatient X-Ray Services have no copay and coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Humana Dual Select H5619-165 (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization and a referral.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice. While the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, all of these sub-services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Dual Select H5619-165 (HMO D-SNP), with a $0 copay for days 1-20 and days 66-100, and a $214 copay for days 21-65; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor's referral are required.
Other Services See details
Under "Other Services," this plan covers acupuncture with a $30 copay, and a limit of 20 treatments per year, and also covers over-the-counter (OTC) items, with a maximum benefit of $1200 per year. The meal benefit has no copay. However, the plan does not cover 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved