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HumanaChoice H7617-018 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-018 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-018 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-018 (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 H7617-018 (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 H7617-018 (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 H7617-018 (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 $350.00 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 HumanaChoice H7617-018 (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay when using a standard pharmacy or preferred mail order. Tier 2 generic drugs are also highly accessible, requiring no copay for a three-month supply through preferred mail order, or a $10 copay for a one-month supply at standard pharmacies. For Tier 3 preferred brand drugs, the plan offers a $47 copay for a one-month supply at standard pharmacies and mail order options. Tier 4 non-preferred drugs require a 50% coinsurance for both one-month and three-month supplies. Tier 5 specialty drugs carry a 25% coinsurance for a one-month supply across standard pharmacies and mail order services.
Additional Benefits
The HumanaChoice H7617-018 (PPO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $25 copay, while inpatient hospital stays carry a $395 daily copay for the first seven days and no copay for additional days. Emergency room visits are covered with a $150 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as routine dental care with a $3,000 annual maximum and no copay for most preventive services. Routine vision and hearing exams are covered with no copay, alongside allowances for eyewear and over-the-counter hearing aids. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HumanaChoice H7617-018 (PPO) covers inpatient acute hospital stays with no coinsurance, requiring a $395 daily copay for days 1 through 7 and no copay for days 8 and beyond. Inpatient psychiatric hospital stays are also covered with no coinsurance, featuring a $360 daily copay for days 1 through 7 and no copay for days 8 through 90, though additional psychiatric days and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice H7617-018 (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services carry a copay of $0 to $300 (or $395 per stay for observation), while outpatient substance abuse individual and group sessions require a $20 to $35 copay.
Partial Hospitalization See details
HumanaChoice H7617-018 (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
HumanaChoice H7617-018 (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. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HumanaChoice H7617-018 (PPO) covers emergency services with a $150 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $65 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $150 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-018 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $25 copay and therapy services require a $40 copay, both with no coinsurance. Mental health, psychiatric, and opioid treatment services are also covered with no coinsurance and copays ranging from $20 to $35, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
HumanaChoice H7617-018 (PPO) preventive services are partially covered, offering no copay and no coinsurance for covered services like annual physical exams, kidney disease education, memory fitness, and glaucoma screenings. However, a wide range of supplemental benefits are not covered under this plan. These non-covered services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access technologies, home modifications, and counseling.
Hearing Services See details
HumanaChoice H7617-018 (PPO) hearing services feature no coinsurance and no deductibles, offering Medicare-covered exams for a $25 copay, alongside routine annual exams and unlimited OTC hearing aids with no copay. Prescription hearing aids are partially covered with a copay ranging from $699 to $999 for up to two devices per year, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HumanaChoice H7617-018 (PPO) offers partially covered vision services with no coinsurance or deductible, featuring no copay for annual routine eye exams (up to $75) and eyewear like contact lenses or eyeglasses (up to $250). Prior authorization is required, and other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-018 (PPO) dental services are partially covered with a combined in- and out-of-network annual maximum of $3,000. Most preventive and comprehensive services have no copay and no coinsurance, but Medicare-covered dental requires a $25 copay (no coinsurance), prosthodontics require a 30% coinsurance (no copay), and fluoride, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-018 (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy may apply. Covered Medicare Part B drugs, including chemotherapy and radiation, require no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice H7617-018 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice H7617-018 (PPO), which offers durable medical equipment (DME) and prosthetics at a 20% coinsurance with 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
HumanaChoice H7617-018 (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests and procedures have no coinsurance and a copay of $0 to $95, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-018 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under the HumanaChoice H7617-018 (PPO) plan with no coinsurance, though prior authorization is required. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-018 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a daily copayment of $20 for days 1 through 20 and $218 for days 21 through 100. Prior authorization is required, and coverage does not require a prior three-day hospital stay, though additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services covered by HumanaChoice H7617-018 (PPO) include acupuncture, which has a $25 copay and no coinsurance for up to 20 treatments per year. Additionally, over-the-counter items and chronic illness meal benefits are covered with no copay and no coinsurance, though prior authorization is required for acupuncture and meals.
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