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Humana Full Access H7617-009 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Full Access H7617-009 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Full Access H7617-009 (PPO) in 2026, please refer to our full plan details page.
Humana Full Access H7617-009 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select counties in Illinois. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Full Access H7617-009 (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 Humana Full Access H7617-009 (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 Humana Full Access H7617-009 (PPO), 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 $2.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $450.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $400.00 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 $4500.00 (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 $4500.00 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 Humana Full Access H7617-009 (PPO) Medicare plan features an annual prescription drug deductible of $400. For Tier 1 preferred generic drugs, there is no copay for 1-month or 3-month supplies at standard retail pharmacies and preferred mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, with 3-month supplies costing $131 through preferred mail order or $141 at standard pharmacies. Tier 4 non-preferred drugs require a 50% coinsurance for both 1-month and 3-month fills. Finally, Tier 5 specialty medications require a 28% coinsurance for a 1-month supply at standard pharmacies and through mail order.
Additional Benefits
The Humana Full Access H7617-009 (PPO) plan offers robust medical coverage featuring no copay for primary care physician visits and a $35 copay for specialists. Inpatient hospital stays require a $425 daily copay for days one through seven, while outpatient hospital services range from no copay up to a $300 copay. Emergency room visits have a $130 copay, which is waived if admitted, and urgently needed services require a $50 copay. For extra wellness benefits, the plan provides dental coverage up to a $3,000 annual maximum with no copay for most preventive and comprehensive services. Routine vision and hearing exams are available with no copay, and members receive a $200 annual allowance for eyewear. Additionally, there is no copay for home health care, and durable medical equipment is covered with a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Humana Full Access H7617-009 (PPO) with no coinsurance, requiring prior authorization. Acute stays require a $425 copay for days 1 to 7 and no copay for days 8 and beyond, while psychiatric stays require a $325 copay for days 1 to 7 and no copay for days 8 to 90; upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under Humana Full Access H7617-009 (PPO) are covered with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Prior authorization is required for most services, with copays ranging from $0 to $300 for outpatient hospital services, $425 per stay for observation services, and $20 to $35 for outpatient substance abuse sessions.
Partial Hospitalization See details
Humana Full Access H7617-009 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Full Access H7617-009 (PPO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services are not covered by this plan.
Emergency Services See details
Humana Full Access H7617-009 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Full Access H7617-009 (PPO) primary care benefits feature no copay for primary care physician visits and a $35 copay for specialist visits, with no coinsurance for either service. Therapy services require a $40 copay, mental health and psychiatric sessions have a $20 copay, and all covered options carry no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Humana Full Access H7617-009 (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and Medicare-covered screenings. Additional preventive benefits are partially covered, providing a memory fitness benefit with no copay and no coinsurance, but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, safety devices, and counseling.
Hearing Services See details
Humana Full Access H7617-009 (PPO) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are partially covered with a $699 to $999 copay and no coinsurance—excluding inner ear, outer ear, and over-the-ear models—while over-the-counter hearing aids are covered with no copay or coinsurance.
Vision Services See details
Vision services are partially covered by Humana Full Access H7617-009 (PPO), which offers one routine eye exam per year with no copay and no coinsurance up to a $75 limit, while other eye exam services are not covered. Eyewear is also partially covered with no copay, no coinsurance, and no deductible up to a $200 annual limit for contact lenses or eyeglasses, but standalone lenses, frames, and upgrades are excluded.
Dental Services See details
Humana Full Access H7617-009 (PPO) partially covers dental services up to a $3,000 annual maximum, offering most preventive and comprehensive care with no copay and no coinsurance. Medicare-covered dental services have a $35 copay and no coinsurance, prosthodontics require a 30% coinsurance and no copay, while fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Full Access H7617-009 (PPO) covers home infusion bundled services with no copay, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs require ranging from no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and ranging from no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Full Access H7617-009 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
Medical Equipment See details
Humana Full Access H7617-009 (PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Full Access H7617-009 (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, no copay for lab services, and a $0 to $95 copay for diagnostic procedures, while radiological services offer no copay for outpatient X-rays and diagnostic radiological services, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Humana Full Access H7617-009 (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Humana Full Access H7617-009 (PPO) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization is required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Full Access H7617-009 (PPO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Full Access H7617-009 (PPO) partially covers other services, which includes acupuncture for a $35 copay and no coinsurance up to 20 treatments per year, as well as over-the-counter (OTC) items and meals for chronic illness with no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, while the Other 1, Other 2, and Other 3 sub-services are not covered.
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