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Humana Value Choice H7617-023 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-023 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Value Choice H7617-023 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-023 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Missouri and Illinois. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Value Choice H7617-023 (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 Value Choice H7617-023 (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 Value Choice H7617-023 (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 $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 $6200.00 (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 $6200.00 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 Value Choice H7617-023 (PPO) 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 cost a $10 copay for a 1-month supply at standard pharmacies, though you can get a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, with 3-month preferred mail-order costs reduced to $131. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance across standard pharmacies and mail-order options. Tier 5 specialty drugs are subject to a 25% coinsurance for a 1-month supply.
Additional Benefits
The Humana Value Choice H7617-023 (PPO) plan offers affordable coverage for core medical needs, featuring no copay for primary care visits and a $30 copay for specialists. If you require hospital services, inpatient stays carry a $375 daily copay for the first seven days with no copay thereafter, while emergency room visits have a $150 copay. Outpatient care and preventive services are highly accessible, with many services requiring no copay and no coinsurance. For supplemental care, this plan provides robust dental benefits with no copay for most preventive and comprehensive services up to a $3,500 annual limit. Routine vision and hearing exams also feature no copay, though prescription hearing aids and specialized vision hardware may require additional copays. Furthermore, home health services and laboratory tests are available with no copay, while durable medical equipment typically carries a 20% coinsurance.
Inpatient Hospital See details
Humana Value Choice H7617-023 (PPO) covers inpatient acute hospital stays with no coinsurance and a $375 copay per day for days 1 through 7, with no copay thereafter for unlimited days. Inpatient psychiatric care is also covered with no coinsurance and a $334 daily copay for days 1 through 7, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Value Choice H7617-023 (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $300, observation services carry a $375 copay per stay, and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Partial hospitalization services are covered under the Humana Value Choice H7617-023 (PPO) plan with a $35.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Humana Value Choice H7617-023 (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. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Humana Value Choice H7617-023 (PPO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-023 (PPO) features no coinsurance for all covered primary care services, including primary care visits with no copay and specialist, therapy, psychiatric, and mental health services with a $30 copay. Telehealth benefits range from no copay to a $65 copay, opioid treatment requires a $35 copay, podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Humana Value Choice H7617-023 (PPO) covers key preventive services—including annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, post-welcome visit EKGs, and memory fitness—with no copay and no coinsurance. Other additional preventive services are only partially covered, as the plan excludes coverage for health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Value Choice H7617-023 (PPO) covers hearing services, offering Medicare-covered exams for a $30 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids have no copay and no coinsurance. Prescription hearing aids are partially covered with a copay between $699 and $999 and no coinsurance, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the Humana Value Choice H7617-023 (PPO) plan with no coinsurance and copays ranging from $0 to $30. While routine eye exams and eyeglasses or contact lenses are covered with no copay, other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered under Humana Value Choice H7617-023 (PPO), with most preventive and comprehensive care offering no copay and no coinsurance up to a $3,500 annual maximum. Medicare-covered dental services require a $30 copay and no coinsurance, prosthodontics require no copay and 30% coinsurance, while fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Value Choice H7617-023 (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy and radiation, have no coinsurance to 20% coinsurance, while covered Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Value Choice H7617-023 (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Value Choice H7617-023 (PPO) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay, and medical supplies with a 15% coinsurance and 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
Humana Value Choice H7617-023 (PPO) covers diagnostic tests and procedures with a 20% coinsurance and a copay of up to $65, while lab services, outpatient X-rays, and diagnostic radiological services are offered with no copay. Therapeutic radiological services require a $30 copay, and all radiological services feature no coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Value Choice H7617-023 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by the Humana Value Choice H7617-023 (PPO) plan with no coinsurance and require prior authorization, although standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Value Choice H7617-023 (PPO) covers Skilled Nursing Facility (SNF) services 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, but a prior three-day hospital stay is not necessary, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Humana Value Choice H7617-023 (PPO) covers acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year, 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 meal benefits, and some other services under this category are not covered.
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