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Humana Value Choice H7617-031 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-031 (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 H7617-031 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-031 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in ID, OR. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Value Choice H7617-031 (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 H7617-031 (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 H7617-031 (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.
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 $6750.00 (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 $6750.00 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 H7617-031 (PPO) Medicare prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies or through preferred mail order. Tier 2 generic drugs cost a $5 copay for a 1-month supply at standard pharmacies, and you can get a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs have a $47 copay for a 1-month supply at standard pharmacies and mail order options. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance for a 1-month supply. This plan offers clear cost-sharing options to help you manage your prescription medication expenses.
Additional Benefits
The Humana Value Choice H7617-031 (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care, preventive services, and home health visits. For inpatient hospital stays, members pay a $450 copay for days 1 to 5 and no copay for subsequent days, while specialist visits and outpatient therapy require a $35 copay. Emergency services are available with a $115 copay, which is waived upon hospital admission, while urgent care visits require a $50 copay. Supplemental care includes dental, vision, and hearing benefits, highlighted by a $2,000 annual maximum for dental services with no copay for most preventive and comprehensive care. Routine eye exams and over-the-counter hearing aids require no copay, and members receive up to a $150 annual limit for eyewear. Durable medical equipment requires a 14% coinsurance, while over-the-counter items and chronic illness meals are covered with no copay.
Inpatient Hospital See details
Humana Value Choice H7617-031 (PPO) covers inpatient acute hospital stays with no coinsurance, a $450 copay for days 1 to 5, and no copay for days 6 and beyond. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $416 copay for days 1 to 5 and no copay for days 6 to 90, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Value Choice H7617-031 (PPO) covers outpatient services with no coinsurance, featuring a $0 to $450 copay for outpatient hospital services and a $450 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 sessions range from no copay to a $35 copay.
Partial Hospitalization See details
Humana Value Choice H7617-031 (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
Humana Value Choice H7617-031 (PPO) covers ambulance services with a $335 copay for ground transport and a $1,250 copay for air transport, with no coinsurance required. While some transportation services are covered, transportation to plan-approved locations or any health-related locations is not covered under this plan.
Emergency Services See details
Humana Value Choice H7617-031 (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 are available for a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-031 (PPO) offers primary care, mental health, and psychiatric services with no copay and no coinsurance. Specialist, physical therapy, and occupational therapy visits require a $35 copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Value Choice H7617-031 (PPO) covers preventive services, including annual physicals, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered with a memory fitness benefit, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home/bathroom safety devices, and counseling are not covered.
Hearing Services See details
Hearing services covered by the Humana Value Choice H7617-031 (PPO) include routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $699 to $999 and no coinsurance, though inner ear, outer ear, and over the ear models are not covered, while over-the-counter (OTC) hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Vision services are covered by Humana Value Choice H7617-031 (PPO) with no coinsurance and copays ranging from $0 to $35 for exams, which includes one routine eye exam per year with no copay. Eyewear is partially covered with no copay or coinsurance up to a $150 annual limit for contacts or complete eyeglasses, though individual lenses, frames, upgrades, and other eye exams are not covered.
Dental Services See details
Humana Value Choice H7617-031 (PPO) partially covers dental services with a $2,000 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive care, and a $35 copay with no coinsurance for Medicare-covered dental. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Value Choice H7617-031 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Humana Value Choice H7617-031 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Humana Value Choice H7617-031 (PPO) covers durable medical equipment, medical supplies, and prosthetic devices with a 14% coinsurance and no copay. Diabetic supplies are covered with a 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 Humana Value Choice H7617-031 (PPO), though prior authorization is required. Lab services and outpatient X-rays feature no copay, diagnostic procedures and tests carry a copay ranging from $0 to $50 with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Humana Value Choice H7617-031 (PPO) covers home health services 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 H7617-031 (PPO) plan with no copay, no coinsurance, and prior authorization required. Although some services are covered, specific sub-services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
Humana Value Choice H7617-031 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20 and days 56 through 100, but a daily copay of $218 applies for days 21 through 55, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Humana Value Choice H7617-031 (PPO) provides partial coverage for other services, including acupuncture for a $35 copay and no coinsurance, 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 other miscellaneous services are not covered.
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