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HumanaChoice H7617-027 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-027 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-027 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-027 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-027 (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 H7617-027 (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 H7617-027 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.00. 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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
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 $13900.00 (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 $13900.00 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 H7617-027 (PPO) plan has an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are available with no copay at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost $5 for a one-month supply, though you can get a three-month supply with no copay when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, which can rise to $141 for a three-month supply depending on your choice of pharmacy. For advanced medications, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 25% coinsurance.
Additional Benefits
The HumanaChoice H7617-027 (PPO) Medicare plan offers affordable coverage for core medical services, featuring no copay and no coinsurance for primary care visits, while specialist visits require a $40 copay. For inpatient hospital stays, members pay a $380 daily copay for the first six days and no copay for additional days. Outpatient hospital services carry no coinsurance with copays ranging from $0 to $350, and emergency room visits require a $115 copay which is waived if you are admitted. This plan also includes key supplemental benefits, such as routine dental, vision, and hearing care with no copay for routine exams, though limits and cost-shares apply for hardware like hearing aids and eyewear. While home health and home infusion services have no copay or coinsurance, durable medical equipment and dialysis services require a 20% coinsurance. Additionally, Medicare Part B chemotherapy and other drugs have a 0% to 20% coinsurance, while diabetic supplies feature a 10% to 20% coinsurance.
Inpatient Hospital See details
HumanaChoice H7617-027 (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute inpatient stays require a $380 copay for days 1 through 6 and no copay for days 7 and beyond, while psychiatric stays carry a $339 copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-027 (PPO) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $350, alongside a $380 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services carry a $30 to $35 copay with no coinsurance.
Partial Hospitalization See details
HumanaChoice H7617-027 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under HumanaChoice H7617-027 (PPO) require prior authorization, featuring a $335 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or health-related locations are not covered by this plan.
Emergency Services See details
HumanaChoice H7617-027 (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-027 (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Additional services like physical, occupational, mental health, and psychiatric therapies are covered with copays ranging from $25 to $30 and no coinsurance, while podiatry is not covered and chiropractic services exclude routine and other care.
Preventive Services See details
HumanaChoice H7617-027 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered care, including annual physical exams, kidney disease education, and diabetes self-management training. However, additional preventive benefits such as fitness programs, health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
HumanaChoice H7617-027 (PPO) covers hearing exams, offering Medicare-covered exams for a $40 copay and routine exams or fitting evaluations with no copay, all with no coinsurance. Prescription hearing aids are partially covered with a copay of $699 to $999 and no coinsurance for up to two devices per year, though inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
HumanaChoice H7617-027 (PPO) vision services are partially covered with no deductible and no coinsurance. Routine eye exams and eyewear (including contact lenses and eyeglasses) are covered with no copay, subject to annual limits of $75 and $150 respectively, while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-027 (PPO) dental services are partially covered, with Medicare-covered dental services requiring a $40 copay and no coinsurance, and other covered dental services requiring no copay and no coinsurance up to a $1,000 yearly maximum. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-027 (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the HumanaChoice H7617-027 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
HumanaChoice H7617-027 (PPO) covers durable medical equipment, prosthetics, and medical supplies with 20% coinsurance and no copay. Diabetic supplies are covered with 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice H7617-027 (PPO) with prior authorization, though copays and coinsurance vary by service. Lab services, outpatient X-rays, and diagnostic radiology have no copay, while diagnostic procedures and tests require a $0 to $40 copay and 20% coinsurance, and therapeutic radiology requires a copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the HumanaChoice H7617-027 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice H7617-027 (PPO) with prior authorization, though only some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered. These rehabilitation services carry a $20 copay for cardiac and intensive cardiac care, and a 20% coinsurance for pulmonary and SET for PAD services.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-027 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, but a prior three-day inpatient hospital stay is not.
Other Services See details
Other services are partially covered by HumanaChoice H7617-027 (PPO), featuring acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for both covered services, and over-the-counter (OTC) items are not covered.
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