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Humana Full Access H7617-020 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Full Access H7617-020 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Full Access H7617-020 (PPO) in 2026, please refer to our full plan details page.
Humana Full Access H7617-020 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Wisconsin. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Full Access H7617-020 (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 Full Access H7617-020 (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 Full Access H7617-020 (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 $2.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $600.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $400.00 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 Humana Full Access H7617-020 (PPO) prescription drug plan features an annual drug deductible of $400. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies and preferred mail order, though you will pay no copay for a 3-month supply when filled via preferred mail order. For higher tier medications, Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply, with a slightly reduced $131 copay for a 3-month supply through preferred mail order. Tier 4 non-preferred drugs require a 48% coinsurance across all pharmacy and mail order services. Specialty drugs in Tier 5 are subject to a 28% coinsurance for a 1-month supply.
Additional Benefits
The Humana Full Access H7617-020 (PPO) plan offers robust healthcare coverage with no copay for primary care doctor visits and a $40 copay for specialists. Inpatient hospital stays require a $430 daily copay for days one through six, with no copay for additional days, while emergency room visits carry a $130 copay that is waived if you are admitted. Outpatient care is highly affordable, featuring no coinsurance and no copay for ambulatory surgical centers. Additionally, the plan provides strong supplemental benefits, including up to $2,000 in dental coverage with no copay for most services, alongside routine vision and hearing exams with no copay. Beneficiaries will also enjoy no copay for home health services and over-the-counter items, though medical equipment and dialysis require a 20% coinsurance. This PPO plan is designed to keep out-of-pocket costs predictable by utilizing fixed copayments and eliminating coinsurance on many key services.
Inpatient Hospital See details
Humana Full Access H7617-020 (PPO) covers inpatient acute hospital stays with no coinsurance and a $430 daily copay for days 1 to 6, with no copay for days 7 and beyond. Inpatient psychiatric care is covered with no coinsurance and a $380 daily copay for days 1 to 6, with no copay for days 7 to 90, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Full Access H7617-020 (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay of $0 to $300, observation services require a $430 copay per stay, and outpatient substance abuse sessions carry a copay of $30 to $35.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Full Access H7617-020 (PPO) with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Full Access H7617-020 (PPO) covers ambulance services with prior authorization, featuring a $335 copay for ground ambulance and 20% coinsurance for air ambulance, neither of which is waived if admitted to the hospital. For transportation, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Humana Full Access H7617-020 (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, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Full Access H7617-020 (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Standard therapies and mental health services are covered with copays ranging from $30 to $35 and no coinsurance, while podiatry is not covered. Some chiropractic services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Humana Full Access H7617-020 (PPO) covers preventive services, including annual physical exams, kidney disease education, and a memory fitness benefit, with no copay and no coinsurance. Additional supplemental preventive benefits are only partially covered, as services such as health education, weight management, nutritional services, and in-home safety assessments are not covered.
Hearing Services See details
Humana Full Access H7617-020 (PPO) hearing services include Medicare-covered exams for a $40 copay and no coinsurance, alongside routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are partially covered with a $199 to $799 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models, while over-the-counter hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by Humana Full Access H7617-020 (PPO) with no copay and no coinsurance for covered services, which include one routine eye exam (up to $75 annually) and one pair of contacts or complete eyeglasses (up to $200 annually). Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Full Access H7617-020 (PPO) up to a $2,000 annual limit for both in- and out-of-network care. Medicare-covered dental services require a $40 copay and no coinsurance, prosthodontics require no copay and a 30% coinsurance, and most other covered services have no copay and no coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Full Access H7617-020 (PPO) covers Home Infusion bundled Services with no copay, subject to prior authorization. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Humana Full Access H7617-020 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Humana Full Access H7617-020 (PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% coinsurance and no copay, while diabetic therapeutic shoes and inserts are covered with a $10 copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Full Access H7617-020 (PPO) covers diagnostic and radiological services, with prior authorization required. Diagnostic services feature no coinsurance, offering no copay for lab services and a $0 to $85 copay for diagnostic procedures, while radiological services range from no copay for X-rays and diagnostic radiology to a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Humana Full Access H7617-020 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Full Access H7617-020 (PPO) covers cardiac rehabilitation services with no coinsurance, though prior authorization is required and only some services are covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease services are not covered, carrying copayments ranging from $15 to $40.
Skilled Nursing Facility (SNF) See details
Humana Full Access H7617-020 (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, though a prior three-day inpatient hospital stay is not required for admission.
Other Services See details
Humana Full Access H7617-020 (PPO) covers acupuncture, over-the-counter (OTC) items, and chronic illness meal benefits, though some other miscellaneous services are not covered. Acupuncture requires a $40 copay and no coinsurance for up to 20 treatments per year, while OTC items and meal benefits are offered with no copay and no coinsurance.
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