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HumanaChoice Giveback H7617-014 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Giveback H7617-014 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Giveback H7617-014 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice Giveback H7617-014 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select counties in Missouri. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Giveback H7617-014 (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 H7617-014 (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 H7617-014 (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 $500.00 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 H7617-014 (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. Tier 2 generic drugs are also highly affordable, costing a $10 copay for a 1-month supply at standard pharmacies, or no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply across standard pharmacies and mail-order options. For higher-tier medications, you will pay a coinsurance rather than a copay, which includes 48% coinsurance for Tier 4 non-preferred drugs and 25% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The HumanaChoice Giveback H7617-014 (PPO) plan offers robust coverage with no copay for primary care doctor visits, annual preventive exams, and home health services. Specialist visits and physical therapy require a $45 copay, while emergency room care has a $130 copay. For inpatient hospital stays, members pay a $450 daily copay for days one through five, with no copay for days six through 90. Supplemental benefits include comprehensive dental coverage with no copay or coinsurance up to a $4,000 annual limit. Routine vision and hearing exams are covered with no copay, while prescription hearing aids require a copay between $199 and $799. Additionally, diagnostic lab work and cardiac rehabilitation are available with no copay, while medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by HumanaChoice Giveback H7617-014 (PPO) with no coinsurance, requiring a $450 daily copay for days 1 through 5 and no copay for days 6 through 90 for both acute and psychiatric stays. Prior authorization is required, and services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice Giveback H7617-014 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a $0 to $300 copay, observation services require a $450 copay per stay, and outpatient substance abuse sessions have a $30 to $35 copay, all with no coinsurance.
Partial Hospitalization See details
HumanaChoice Giveback H7617-014 (PPO) covers partial hospitalization services with a $35 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
HumanaChoice Giveback H7617-014 (PPO) covers ambulance services with prior authorization, requiring a $335 copay and no coinsurance for ground ambulance services, and a 20% coinsurance and no copay for air ambulance services. Transportation services are not covered.
Emergency Services See details
HumanaChoice Giveback H7617-014 (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 available with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice Giveback H7617-014 (PPO) primary care benefits feature no copay and no coinsurance for primary care physician visits, while specialist visits and physical, occupational, and speech therapies require a $45 copay and no coinsurance. Mental health and psychiatric sessions have a $30 copay with no coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive Services under HumanaChoice Giveback H7617-014 (PPO) are partially covered with no copay and no coinsurance for annual exams, kidney disease education, fitness benefits, and select screenings. However, several supplemental services are not covered, including health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
HumanaChoice Giveback H7617-014 (PPO) hearing services cover Medicare-covered exams for a $45 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids are provided with no copay or coinsurance. Prescription hearing aids are partially covered with copays ranging from $199 to $799 and no coinsurance for up to two devices per year, though inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice Giveback H7617-014 (PPO), featuring no coinsurance and no deductibles, with no copay for covered eyewear and a $0 to $45 copay for eye exams. Annual maximum benefits are limited to $75 for exams and a combined $100 for select eyewear, while upgrades, separate lenses or frames, and other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice Giveback H7617-014 (PPO) up to a $4,000 combined in- and out-of-network annual limit, offering no copay and no coinsurance for most preventive and comprehensive care. Medicare-covered dental services require a $45 copay and no coinsurance, prosthodontics require a 30% coinsurance with no copay, and fluoride treatments, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
HumanaChoice Giveback H7617-014 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs feature no copay and range from no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
HumanaChoice Giveback H7617-014 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment is covered by HumanaChoice Giveback H7617-014 (PPO), which offers durable medical equipment and prosthetic devices at a 20% coinsurance with no copay. Medical supplies are covered with a 7% coinsurance and no copay, while diabetic supplies require a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts incur a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice Giveback H7617-014 (PPO) covers diagnostic procedures and tests with a $0 to $50 copay and 20% coinsurance, while lab services are covered with no copay. Radiological services require prior authorization and have no coinsurance, featuring no copay for outpatient X-rays and diagnostic radiology, and a copay starting at $30 for therapeutic radiology.
Home Health Services See details
HumanaChoice Giveback H7617-014 (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
Cardiac Rehabilitation Services are offered with no copay or coinsurance under the HumanaChoice Giveback H7617-014 (PPO) plan, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are partially covered by HumanaChoice Giveback H7617-014 (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 additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under the HumanaChoice Giveback H7617-014 (PPO) are partially covered, offering acupuncture for a $45 copay and no coinsurance up to 20 treatments per year, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, while other miscellaneous services are not covered.
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