A non-government entity
HumanaChoice H7617-016 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-016 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-016 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-016 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in UT, WA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-016 (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 H7617-016 (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 H7617-016 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $87.00. 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 has a $100.00 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:
Sign up for HumanaChoice H7617-016 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HumanaChoice H7617-016 (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies and through preferred mail order. Tier 2 generic drugs have a $5 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, or $131 for a 3-month supply through preferred mail order. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance for both 1-month and 3-month supplies. Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply across standard pharmacies and mail order options.
Additional Benefits
The HumanaChoice H7617-016 (PPO) plan offers affordable coverage with no copay and no coinsurance for primary care visits, preventive care services, and home health care. For specialized medical care, members pay a $35 copay for specialist visits, a $130 copay for emergency room visits, and a $325 daily copay for the first four days of an inpatient hospital stay. Outpatient hospital services generally require a $0 to $35 copay and 20% coinsurance. Additional benefits include no copay for routine vision and hearing exams, with prescription hearing aids requiring copays between $699 and $999. Preventive dental services, endodontics, and oral surgery are fully covered with no copay up to a $1,000 annual limit, while durable medical equipment requires a 20% coinsurance. Skilled nursing facility stays are also covered with no copay for the first 20 days.
Inpatient Hospital See details
HumanaChoice H7617-016 (PPO) covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1 through 4 and no copay for days 5 through 90 per stay. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice H7617-016 (PPO) covers outpatient hospital services with a $0 to $35 copay and 20% coinsurance, and ambulatory surgical center services with no copay and 20% coinsurance. Outpatient substance abuse services require a $0 to $35 copay and no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
HumanaChoice H7617-016 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
HumanaChoice H7617-016 (PPO) covers ambulance services with no coinsurance, requiring a $335 copay for ground transport and a $1,250 copay for air transport. Transportation services are not covered under this plan.
Emergency Services See details
Emergency services are covered by HumanaChoice H7617-016 (PPO) 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, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-016 (PPO) offers primary care physician visits, psychiatric services, and mental health specialty services with no copay and no coinsurance. Specialist visits carry a $35 copay, therapy services require a $30 copay, and telehealth benefits range from a $0 to $50 copay, all with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
HumanaChoice H7617-016 (PPO) preventive services, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management, are covered with no copay and no coinsurance. Additional preventive services are only partially covered, as the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, or nutritional services.
Hearing Services See details
HumanaChoice H7617-016 (PPO) covers hearing exams with a $35 copay and no coinsurance for Medicare-covered visits, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $699 to $999 and no coinsurance, but inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
HumanaChoice H7617-016 (PPO) offers partially covered vision services with no deductibles and no coinsurance, featuring no copay for routine eye exams (and up to a $35 copay for other exams) and no copay for covered eyewear. While annual maximum allowances apply to these services, other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice H7617-016 (PPO) up to a $1,000 annual limit, featuring no copay and no coinsurance for preventive care, endodontics, periodontics, and oral surgery, while restorative and fixed prosthodontics require a 30% to 40% coinsurance and no copay. Medicare-covered dental services require a $35 copay and no coinsurance, but fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and removable prosthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-016 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, require from no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by HumanaChoice H7617-016 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice H7617-016 (PPO), featuring durable medical equipment (DME), prosthetics, and medical supplies with a 20% coinsurance and no copay. Covered diabetic supplies have no copay and 10% to 20% coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-016 (PPO) covers diagnostic services with no coinsurance, featuring no copay for lab services and a $0 to $50 copay for diagnostic procedures and tests. Covered radiological services include outpatient x-rays with no copay and a minimum 20% coinsurance, and therapeutic radiological services with a copayment and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-016 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice H7617-016 (PPO) covers some cardiac rehabilitation services with a $10 copay, no coinsurance, and prior authorization required. However, 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 HumanaChoice H7617-016 (PPO) with no coinsurance and do not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 to 20 and days 66 to 100, a $218 daily copay for days 21 to 65, and additional days beyond the standard 100 days are not covered.
Other Services See details
HumanaChoice H7617-016 (PPO) offers partially covered other services, including acupuncture with a $35 copay and no coinsurance for up to 20 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered, and prior authorization is required for the covered services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved