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Humana Value Choice H7617-010 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-010 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Value Choice H7617-010 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-010 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Kansas City, MO-KS. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Value Choice H7617-010 (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 Value Choice H7617-010 (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 Value Choice H7617-010 (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 $1.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $250.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $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 $6300.00 (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 $6300.00 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 Value Choice H7617-010 (PPO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order, though standard mail order costs up to a $10 copay for one month. Tier 2 generic drugs require a $10 copay for a 1-month supply at standard pharmacies and preferred mail order, but you can get a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply at standard pharmacies and mail order, with savings on 3-month supplies starting at $131 through preferred mail order. For Tier 4 non-preferred drugs, you will pay a 50% coinsurance for both 1-month and 3-month supplies across standard pharmacies and mail order channels. Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply at standard pharmacies and through both mail order options.
Additional Benefits
The Humana Value Choice H7617-010 (PPO) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits and preventive services. Specialist visits, physical therapy, and mental health services require a $30 copay, while inpatient hospital stays carry a daily copay of $375 for the first seven days of an acute stay. Emergency care is covered with a $150 copay, which is waived if you are admitted, and urgent care visits carry a $65 copay. For routine care, the plan provides dental coverage up to a $2,500 annual limit with no copay for most preventive services, alongside routine vision and hearing exams with no copay. Home health services are fully covered with no copay, while durable medical equipment and prosthetic devices require a 20% coinsurance. Members also benefit from daily copays starting at $10 for the first 20 days of skilled nursing facility care and no copay for over-the-counter items.
Inpatient Hospital See details
Humana Value Choice H7617-010 (PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $375 for days 1-7 of an acute stay and $334 for days 1-7 of a psychiatric stay, with no copay for remaining covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
Humana Value Choice H7617-010 (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $300, observation services carry a $375 copay per stay, and outpatient substance abuse services have a copay of $30 to $35 with no coinsurance. Prior authorization is required for these outpatient benefits.
Partial Hospitalization See details
Humana Value Choice H7617-010 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Humana Value Choice H7617-010 (PPO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Humana Value Choice H7617-010 (PPO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-010 (PPO) features primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a $30 copay and no coinsurance. Telehealth benefits are available with a $0 to $65 copay and no coinsurance, but podiatry is not covered and only some chiropractic services are covered, excluding routine and other chiropractic care.
Preventive Services See details
Preventive services are covered by Humana Value Choice H7617-010 (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, memory fitness, and diabetes or glaucoma screenings. Additional preventive benefits are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Humana Value Choice H7617-010 (PPO) covers hearing exams, featuring a $30 copay and no coinsurance for Medicare-covered exams, and no copay and no coinsurance for routine exams and fitting evaluations. Hearing aids are partially covered, offering over-the-counter models with no copay and no coinsurance, and prescription models with a $699 to $999 copay and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Value Choice H7617-010 (PPO) provides partially covered vision services with no copay, no coinsurance, and no deductible for routine eye exams and covered eyewear, though prior authorization is required. Standalone eyeglass lenses, standalone eyeglass frames, upgrades, and other eye exam services are not covered by the plan.
Dental Services See details
Humana Value Choice H7617-010 (PPO) dental services are partially covered up to a $2,500 annual maximum, requiring no copay and no coinsurance for most preventive, diagnostic, and restorative services. Medicare-covered dental services require a $30 copay (no coinsurance), prosthodontics require a 30% coinsurance (no copay), and fluoride treatments, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Value Choice H7617-010 (PPO) with no copay, although prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a 0% to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Humana Value Choice H7617-010 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Humana Value Choice H7617-010 (PPO) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay, and medical supplies with a 15% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Value Choice H7617-010 (PPO), with prior authorization required for all services. Diagnostic procedures and tests have a 20% coinsurance and a copay of $0 to $65, while lab services and outpatient X-rays are covered with no copay. Diagnostic radiological services feature no coinsurance and a $0 minimum copay, while therapeutic radiological services have no coinsurance and a minimum copay of $30.
Home Health Services See details
Humana Value Choice H7617-010 (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required before you can receive these services.
Cardiac Rehabilitation Services See details
Humana Value Choice H7617-010 (PPO) provides Cardiac Rehabilitation Services with no coinsurance and required prior authorization, though only some services are covered in practice. Under this plan, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Humana Value Choice H7617-010 (PPO) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day hospital stay is not necessary, additional days beyond the standard 100 days are not covered.
Other Services See details
Humana Value Choice H7617-010 (PPO) partially covers other services, offering acupuncture with a $30 copay and no coinsurance, as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Unspecified other services (Other 1, 2, and 3) and highly integrated dual eligible SNP services are not covered.
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