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HumanaChoice H7617-007 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-007 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-007 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-007 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in AR,MO,OK,WI. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-007 (PPO) 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 HumanaChoice H7617-007 (PPO).
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 H7617-007 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $47.00. 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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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 H7617-007 (PPO) Medicare plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you pay a $5.00 copay for Tier 1 preferred generic drugs at standard pharmacies and preferred mail-order, or a $47.00 copay for Tier 2 standard generics. Tier 3 preferred brands and Tier 4 non-preferred drugs require 50% and 25% coinsurance, respectively, until total drug costs reach $2,100.00. Once your annual out-of-pocket drug costs exceed $2,100.00, you enter the catastrophic coverage phase and pay nothing for your covered Part D prescription drugs. Additionally, beneficiaries who qualify for Extra Help can see their Part D premium reduced from the standard $47.00 down to $21.70.
Additional Benefits
The HumanaChoice H7617-007 (PPO) plan offers comprehensive medical coverage with no copay for primary care physician visits, though specialist visits require a $50 copay. For hospital stays, inpatient acute care requires a $362 daily copay for the first seven days, after which there is no copay or coinsurance for subsequent days. Emergency medical care is available with a $115 copay, which is waived if you are admitted within 24 hours, while urgently needed services carry a $40 copay. This plan also features no copay for preventive dental services and routine hearing exams, while routine eye exams carry a copay of up to $50. Skilled nursing facility stays require no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. Additionally, most durable medical equipment and dialysis services require a 20% coinsurance, while lab services and outpatient x-rays are covered with no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by HumanaChoice H7617-007 (PPO), with acute care requiring a $362 daily copay for days 1-7 and psychiatric care requiring a $276 daily copay for days 1-7, with no copay or coinsurance for subsequent days. Unlimited additional acute care days are covered with no copay or coinsurance, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-007 (PPO) covers outpatient services, including outpatient hospital care for a $0 to $50 copay and 20% coinsurance, and ambulatory surgical center services with no copay and 20% coinsurance. Observation services require a $362 copay per stay, outpatient substance abuse sessions have a $30 copay and 20% coinsurance, and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
HumanaChoice H7617-007 (PPO) covers partial hospitalization services with a $35 copay and no coinsurance. Prior authorization is required to receive coverage for these benefits.
Ambulance and Transportation Services See details
HumanaChoice H7617-007 (PPO) partially covers ambulance and transportation services, as transportation services to health-related locations are not covered. Prior authorization is required for ambulance services, which cost a $335 copay and no coinsurance for ground transport, or a 20% coinsurance and no copay for air transport.
Emergency Services See details
HumanaChoice H7617-007 (PPO) 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 require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Primary Care benefits under HumanaChoice H7617-007 (PPO) are partially covered, featuring no copay and no coinsurance for primary care physician visits, a $50 copay for specialist visits, and 20% coinsurance for physical, occupational, and speech therapies. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by HumanaChoice H7617-007 (PPO) with no copay and no coinsurance for covered options like annual physicals, memory fitness, kidney education, and glaucoma screenings. Supplemental services such as health education, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and in-home support are not covered.
Hearing Services See details
HumanaChoice H7617-007 (PPO) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. Prescription hearing aids are partially covered with a $699 to $999 copay and no coinsurance for up to two aids yearly, though OTC hearing aids and inner, outer, or over the ear prescription models are not covered.
Vision Services See details
HumanaChoice H7617-007 (PPO) covers eye exams with a copay of $0 to $50 and no coinsurance, up to a $75 annual limit. Eyewear is partially covered with no copay and no coinsurance up to a $100 annual limit, though separate eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-007 (PPO) partially covers dental services, offering preventive care like exams, cleanings, and x-rays with no copay and no coinsurance, while Medicare dental services require a $50 copay and no coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered, although several restorative and surgical procedures are available as optional supplemental benefits.
Home Infusion bundled Services See details
HumanaChoice H7617-007 (PPO) covers Home Infusion bundled Services, which require prior authorization and may be subject to step therapy. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy and other Part B drugs are covered with no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice H7617-007 (PPO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive these covered dialysis services.
Medical Equipment See details
Medical Equipment is covered under HumanaChoice H7617-007 (PPO), with prior authorization required for most services. Durable medical equipment, prosthetics, and medical supplies carry a 20% coinsurance with no copay, while diabetic supplies require a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-007 (PPO) covers diagnostic and radiological services, which generally require a 20% coinsurance and prior authorization. There is no copay for lab and outpatient x-ray services, while copays for diagnostic tests range up to $50 and diagnostic radiological services cost up to $335.
Home Health Services See details
HumanaChoice H7617-007 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HumanaChoice H7617-007 (PPO) plan, as all sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD), are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-007 (PPO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, though additional days beyond Medicare-covered stays are not covered. There is no copay and no coinsurance for days 1 through 20, while days 21 through 100 require a $218 copay and no coinsurance.
Other Services See details
HumanaChoice H7617-007 (PPO) partially covers other services, providing acupuncture with a $50 copay and no coinsurance for up to 20 treatments per year, and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for these covered benefits, while over-the-counter items and dual eligible SNPs with highly integrated services are not covered.
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