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HumanaChoice SNP-DE H7284-003 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H7284-003 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice SNP-DE H7284-003 (PPO D-SNP) in 2025, please refer to our full plan details page.
HumanaChoice SNP-DE H7284-003 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Panhandle. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that HumanaChoice SNP-DE H7284-003 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice SNP-DE H7284-003 (PPO 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 HumanaChoice SNP-DE H7284-003 (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.
For HumanaChoice SNP-DE H7284-003 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. 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 combined Maximum Out-Of-Pocket cost of $10000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. The plan's premium may be reduced if you qualify for the low-income subsidy. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have a mix of coinsurance and no copay options, with some services like ambulance and emergency services having copays or coinsurance. The plan also includes coverage for preventive services, hearing, vision, and dental, with specific cost-sharing details for each. This plan covers a variety of other services, including home health, skilled nursing, and medical equipment, often with no copay or coinsurance. There are also additional benefits such as acupuncture and a meal benefit, both with no copay. However, some services are not covered, such as podiatry, orthodontics, and additional hours of care and personal care services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital-Acute, you pay a $450 copay for days 1-4, and no copay for days 5-90; for days 91-999, there is no copay. For Inpatient Hospital Psychiatric, you pay a $450 copay for days 1-3, and no copay for days 4-90.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 20% to 40% coinsurance and no copay, Observation Services with a $450 copay, and Ambulatory Surgical Center (ASC) Services with no copay and 20% coinsurance. Outpatient Substance Abuse Services, including individual and group sessions, have a 20% coinsurance. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan. Emergency Services has a $125 copay, while Urgently Needed Services has a 20% coinsurance, and Worldwide Emergency Services has a $125 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan covers primary care physician services with no copay, chiropractic services with 20% coinsurance, occupational therapy services with 20% coinsurance, physician specialist services with 20% coinsurance, and mental health specialty services with 20% coinsurance. The plan also covers other health care professional services with 20% coinsurance, psychiatric services with 20% coinsurance, physical therapy and speech-language pathology services with 20% coinsurance, additional telehealth benefits with 20% coinsurance and no copay, and opioid treatment program services with 20% coinsurance. Podiatry services are not covered.
Preventive Services See details
Preventive Services includes coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with a copay; some services such as Health Education, and In-Home Safety Assessment are not covered. The plan also covers wigs for hair loss related to chemotherapy, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing Services include routine hearing exams with a 20% coinsurance, fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a maximum benefit of $1,000 every three years. This plan also covers OTC hearing aids with no copay up to $1,000 every three years, and prescription hearing aids, with a maximum of 2 hearing aids every three years, but does not cover prescription hearing aids - inner ear, outer ear, or over the ear.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay and a 20% coinsurance, with coverage for routine eye exams. Eyewear has no copay, and includes coverage for contact lenses and eyeglasses (lenses and frames); however, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
For the HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan, dental services are covered. Medicare dental services have a 20% coinsurance. Other dental services have a maximum benefit of $3,000 per year, with oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, prosthodontics, fixed, and oral and maxillofacial surgery all covered with no copay, but limited visits. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is no copay, and the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan. You will pay a 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with an 18% coinsurance, Prosthetic Devices with a 20% coinsurance, and Medical Supplies with a 20% coinsurance. This plan also covers Diabetic Equipment, including Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, both with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic procedures/tests, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services have a coinsurance of at most 20%, while lab services have a coinsurance of at most 20% and no copay; outpatient X-ray services also have no copay.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not specify the cost sharing details. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HumanaChoice SNP-DE H7284-003 (PPO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $178 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services include acupuncture and a meal benefit, both with prior authorization. Acupuncture has no copay and the plan covers up to 25 treatments per year, while the meal benefit also has no copay. Over-the-counter items, dual eligible SNPs with highly integrated services, 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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