Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H7617-036 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice SNP-DE H7617-036 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in MT. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice SNP-DE H7617-036 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice SNP-DE H7617-036 (PPO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Below are a few key facts and commonly-asked questions about HumanaChoice SNP-DE H7617-036 (PPO D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For HumanaChoice SNP-DE H7617-036 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. 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 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.
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The HumanaChoice SNP-DE H7617-036 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, beneficiaries enjoy no copay for both 1-month and 3-month supplies at standard pharmacies and through preferred mail order. Standard mail order options for these generic tiers incur copayments ranging from $10 to $60 depending on the tier and supply duration. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a consistent 25% coinsurance at standard pharmacies, preferred mail order, and standard mail order. This straightforward cost-sharing structure helps Medicare beneficiaries easily project their annual out-of-pocket medication expenses.
The HumanaChoice SNP-DE H7617-036 (PPO D-SNP) plan offers comprehensive healthcare coverage, including inpatient hospital stays with no coinsurance and a copay of $2,230 for acute stays or $2,080 for psychiatric stays. Outpatient services, primary care, and specialist visits feature no copay and a 20% coinsurance. Emergency care requires a $115 copay that is waived upon admission, while preventive care and home health services are available with no copay and no coinsurance. For supplemental care, the plan provides routine hearing and vision services with no copay and a 20% coinsurance, alongside hearing aid coverage and up to $250 annually for eyewear with no copay or coinsurance. Dental benefits are robust, offering up to a $4,000 annual limit for dental services with no copay or coinsurance. Members also receive extra benefits like over-the-counter items, chronic illness meals, and up to 12 one-way transportation trips per year with no copay or coinsurance.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a copayment of $2,230 per acute stay and $2,080 per psychiatric stay. Non-Medicare-covered stays, upgrades, and additional days for psychiatric care are not covered.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for these services, and there is no deductible for outpatient blood services.
Partial hospitalization is covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers ground ambulance services with a $335 copay and air ambulance services with a 20% coinsurance, with prior authorization required. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, while trips to any health-related location are not covered.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is 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, and transportation services are covered with a $115 copay and no coinsurance.
Primary care and specialist services are covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with no copay and a 20% coinsurance, while telehealth benefits have a copay ranging from $0 to $40 and a 20% coinsurance. Chiropractic services are partially covered with routine chiropractic care excluded, and podiatry services are not covered.
Preventive services are partially covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with no copay and no coinsurance for covered care such as annual physicals, kidney disease education, and diabetes training. However, several sub-services are not covered, including health education, PERS, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, remote access, home modifications, and counseling.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers hearing services with no deductible, offering one routine hearing exam per year for a 20% coinsurance and no copay, alongside fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance for up to two aids every three years (inner ear, outer ear, and over the ear models are not covered), while over-the-counter hearing aids are covered with no copay or coinsurance.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) offers partially covered vision services, which include one routine eye exam per year with no copay and 20% coinsurance up to a $75 limit. Covered eyewear has no copay and no coinsurance up to a $250 annual limit for contact lenses and eyeglasses (lenses and frames), but other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $4,000 annual limit. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers home infusion bundled services and associated Medicare Part B drugs with prior authorization and applicable step therapy. Covered chemotherapy, radiation, insulin, and other Part B drugs carry a 0% to 20% coinsurance, with insulin requiring a $35 copay and other Part B drugs having no copay.
Dialysis services are covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with a 20% coinsurance and no copay. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and radiological services are covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with prior authorization and a 20% coinsurance for all services. Members will pay no copay for lab services, a $0 to $40 copay for diagnostic tests, a $40 copay for X-rays, and a $200 copay for diagnostic radiological services.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services are covered by HumanaChoice SNP-DE H7617-036 (PPO D-SNP) with no copay and prior authorization, though some services are not covered, including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, which require a 20% coinsurance.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 to 20 and days 86 to 100, a $218 daily copay for days 21 to 85, and additional days beyond the standard Medicare-covered limit are not covered.
HumanaChoice SNP-DE H7617-036 (PPO D-SNP) provides partially covered other services, including acupuncture with no copay and a 20% coinsurance for up to 20 treatments per year. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, while other miscellaneous services are not covered.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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