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HumanaChoice Giveback H7617-013 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Giveback H7617-013 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Giveback H7617-013 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice Giveback H7617-013 (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 HumanaChoice Giveback H7617-013 (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 Giveback H7617-013 (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 Giveback H7617-013 (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 $71.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $750.00 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 $10100.00 (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 $10100.00 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 Giveback H7617-013 (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a one-month or three-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost $5 for a one-month supply at standard pharmacies, but you can enjoy no copay for a three-month supply through preferred mail order. Tier 3 preferred brand drugs cost $47 for a one-month supply at standard pharmacies and through mail order. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. Understanding these copays and coinsurance rates helps you maximize your benefits and manage your healthcare budget with this Medicare plan.
Additional Benefits
The HumanaChoice Giveback H7617-013 (PPO) plan offers comprehensive medical coverage with no copay for primary care visits and no deductible for many key services. Inpatient hospital stays require a $450 daily copay for the first five days and no copay for days six through ninety, while outpatient hospital services feature copays ranging from no copay up to $300. Emergency care is available with a $130 copay, which is waived upon hospital admission, and specialist visits require a $40 copay. For supplemental care, this plan provides preventive dental services with no copay up to a $2,500 annual limit, alongside vision and hearing benefits that feature no deductibles and no copays for routine exams. Prescription hearing aids require copays between $199 and $799, while durable medical equipment and dialysis services require a 20% coinsurance. Additionally, prescription Part B drugs carry up to a 20% coinsurance, while home health services and routine lab tests are covered with no copay.
Inpatient Hospital See details
HumanaChoice Giveback H7617-013 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $450 daily copay for days 1 to 5 and no copay for days 6 to 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice Giveback H7617-013 (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $300 copay and observation services with a $450 copay per stay. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $30 to $35 copay.
Partial Hospitalization See details
HumanaChoice Giveback H7617-013 (PPO) 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
Ambulance and transportation services are covered by HumanaChoice Giveback H7617-013 (PPO), requiring a $335 copay and no coinsurance for ground ambulance, and a 20% coinsurance with no copay for air ambulance. Prior authorization is required for all ambulance services, and transportation services to health-related locations are not covered.
Emergency Services See details
HumanaChoice Giveback H7617-013 (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 require a $50 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice Giveback H7617-013 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and occupational therapy require a $40 copay and no coinsurance. Mental health, psychiatric, and telehealth services have copays ranging up to $30 or $50 with no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by HumanaChoice Giveback H7617-013 (PPO) with no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, diabetes training, rectal exams, and EKGs. Additional preventive services are only partially covered; a memory fitness benefit is included with no copay and no coinsurance, but health education, in-home safety, PERS, medical nutrition, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling are not covered.
Hearing Services See details
Hearing services are covered by HumanaChoice Giveback H7617-013 (PPO) with no deductible, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with a copay ranging from $199 to $799 and no coinsurance for up to two devices per year, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice Giveback H7617-013 (PPO), offering copays from $0 to $40, no coinsurance, and no deductibles for covered services. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered, while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice Giveback H7617-013 (PPO) partially covers dental services up to a $2,500 annual limit, with no copay and no coinsurance for most preventive and comprehensive services. Prosthodontics require a 30% coinsurance with no copay and Medicare-covered dental has a $40 copay with no coinsurance, while fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice Giveback H7617-013 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and radiation, require no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice Giveback H7617-013 (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical Equipment is covered by HumanaChoice Giveback H7617-013 (PPO), with durable medical equipment, prosthetics, and medical supplies requiring a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice Giveback H7617-013 (PPO) covers diagnostic and radiological services, offering lab services and outpatient X-rays with no copay, and diagnostic tests with no coinsurance and a copay ranging from $0 to $95. Diagnostic radiological services have a copay starting at $0, while therapeutic radiological services require a minimum 20% coinsurance, with prior authorization required for these benefits.
Home Health Services See details
Home Health Services are covered by HumanaChoice Giveback H7617-013 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice Giveback H7617-013 (PPO) covers cardiac rehabilitation services with no coinsurance and prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice Giveback H7617-013 (PPO) covers Skilled Nursing Facility (SNF) services 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, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services covered by the HumanaChoice Giveback H7617-013 (PPO) include acupuncture for a $40 copay and no coinsurance (up to 20 treatments annually), as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and certain benefits like Dual Eligible SNPs and other miscellaneous services are not covered.
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