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Humana Total Complete H5619-177 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Total Complete H5619-177 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Total Complete H5619-177 (HMO) in 2026, please refer to our full plan details page.
Humana Total Complete H5619-177 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in ID. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Total Complete H5619-177 (HMO) 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 Humana Total Complete H5619-177 (HMO).
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 Total Complete H5619-177 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. You must continue to pay paying your reduced 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 $6400.00 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 Total Complete H5619-177 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members enjoy no copay for both 1-month and 3-month supplies at standard pharmacies or through preferred mail order. Tier 2 generic drugs cost $5 for a 1-month supply at standard pharmacies, while a 3-month supply through preferred mail order carries no copay. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, with a discounted $131 copay for a 3-month supply when using preferred mail order. For Tier 4 non-preferred drugs and Tier 5 specialty drugs, cost-sharing transitions to coinsurance, requiring 50% and 25% coinsurance respectively. This structured tier system allows you to easily project your medication expenses and maximize savings using preferred mail order services.
Additional Benefits
The Humana Total Complete H5619-177 (HMO) plan offers robust core medical coverage with no copay for primary care visits, preventive screenings, and home health care. For inpatient hospital stays, members pay a $450 daily copay for days one through five, followed by no copay for additional days, with no coinsurance required. Emergency room visits carry a $115 copay, which is waived upon admission, while outpatient diagnostic lab work and x-rays require no copay. Specialist visits require a $25 copay, while routine vision and dental preventive care are covered with no copay. The plan also provides up to $150 annually for eyewear and a $1,500 annual limit for dental services, which require 0% to 40% coinsurance for non-preventive care. For medical equipment and dialysis, members will pay no copay alongside a 14% and 20% coinsurance, respectively.
Inpatient Hospital See details
Humana Total Complete H5619-177 (HMO) covers inpatient acute hospital stays with no coinsurance and a $450 copay per day for days 1 to 5, and no copay for days 6 and beyond. Inpatient psychiatric stays are covered with no coinsurance and a $416 copay per day for days 1 to 5 (no copay for days 6 to 90), though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Total Complete H5619-177 (HMO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $450 for outpatient hospital and observation services, and $0 to $35 for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for most services.
Partial Hospitalization See details
Humana Total Complete H5619-177 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Humana Total Complete H5619-177 (HMO) covers ground ambulance services with a $335 copay and air ambulance services with a $1,250 copay, with no coinsurance required for either service, while transportation services are not covered.
Emergency Services See details
Humana Total Complete H5619-177 (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Total Complete H5619-177 (HMO) covers primary care physician visits, mental health, and psychiatric services with no copay and no coinsurance. Specialist visits require a $25 copay, while physical, occupational, and speech therapies carry a $35 copay, all with no coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Humana Total Complete H5619-177 (HMO) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. Additional preventive services are only partially covered, offering a memory fitness benefit with no copay but excluding health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Humana Total Complete H5619-177 (HMO), offering Medicare-covered exams for a $25 copay and no coinsurance, while routine exams and fitting evaluations have no copay or coinsurance. Prescription hearing aids are covered with no coinsurance and copays ranging from $699 to $999, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Humana Total Complete H5619-177 (HMO) features partially covered vision services with no deductible, no copay, and no coinsurance for covered care, which includes one routine eye exam and up to $150 annually for contact lenses or eyeglasses (lenses and frames). Prior authorization is required, and other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Total Complete H5619-177 (HMO) offers partially covered dental services with a $1,500 annual limit, requiring a $25 copay and no coinsurance for Medicare-covered dental, and no copay with 0% to 40% coinsurance for other services. While preventive exams, cleanings, and x-rays have no copay and no coinsurance, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Total Complete H5619-177 (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Total Complete H5619-177 (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Total Complete H5619-177 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 14% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Total Complete H5619-177 (HMO), offering lab services and outpatient X-rays with no copay. Outpatient diagnostic procedures have a copay of up to $50 with no coinsurance, while diagnostic radiological services start at a $0 copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Humana Total Complete H5619-177 (HMO) covers home health services with no copay and no coinsurance. Prior authorization is required for these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Humana Total Complete H5619-177 (HMO) with no coinsurance and require prior authorization. While some services are covered, standard cardiac and intensive cardiac rehabilitation (each with a $10 copay), as well as pulmonary and SET for PAD rehabilitation services (each with a $5 copay), are not covered.
Skilled Nursing Facility (SNF) See details
Humana Total Complete H5619-177 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. You will pay no copay for days 1 to 20 and days 56 to 100, a $218 daily copay for days 21 to 55, and additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
Humana Total Complete H5619-177 (HMO) partially covers other services, offering acupuncture with a $25.00 copay and no coinsurance for up to 20 treatments yearly, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for these covered services, and over-the-counter (OTC) items are not covered.
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