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HumanaChoice H7617-040 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-040 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-040 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-040 (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 H7617-040 (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 H7617-040 (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 H7617-040 (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 $420.00 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 $8950.00 (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 $8950.00 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 H7617-040 (PPO) plan features an annual drug deductible of $420 before coverage begins for higher-tier medications. 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 are also highly affordable, costing a $5 copay for a 1-month supply at standard pharmacies or no copay for a 3-month supply through preferred mail order. For Tier 3 preferred brand drugs, copays start at $45 for a 1-month supply at standard pharmacies and preferred mail order. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 46% coinsurance and Tier 5 specialty drugs requiring 28% coinsurance. These structured cost-sharing tiers help you easily project your out-of-pocket prescription drug costs under this Humana Medicare plan.
Additional Benefits
The HumanaChoice H7617-040 (PPO) plan offers robust coverage for essential medical services, featuring no copay and no coinsurance for primary care visits and routine preventive care. For specialist visits, outpatient procedures, and emergency room care, members will pay flat copayments with no coinsurance, such as a $30 copay for specialists and a $130 copay for emergency services. Inpatient hospital stays require a $310 daily copay for the first six days, after which there is no copay for days seven through 90. This plan also includes valuable supplemental benefits, providing no copay for routine hearing exams, covered eyewear, and select dental services up to a $2,000 annual limit. While home health care and lab services are available with no copay or coinsurance, other services like medical equipment and dialysis require a 20% coinsurance. Additionally, members can access acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by HumanaChoice H7617-040 (PPO) with no coinsurance, requiring a $310 daily copay for days 1 through 6 and no copay for days 7 through 90 per stay. While unlimited additional acute care days are covered with no copay, psychiatric additional days, room upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice H7617-040 (PPO) covers outpatient services with no coinsurance, featuring a $0 to $335 copay for outpatient hospital services, a $310 copay per stay for observation services, and a $30 to $35 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the HumanaChoice H7617-040 (PPO) plan with a $35.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by HumanaChoice H7617-040 (PPO), which features a $335 copay with no coinsurance for ground ambulance services and a 20% coinsurance with no copay for air ambulance services. Prior authorization is required for ambulance transport, and routine transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
HumanaChoice H7617-040 (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 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-040 (PPO) offers primary care physician visits with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Physical, occupational, and speech therapies require a $25 copay, mental health services have a $30 copay, and telehealth ranges from no copay to a $50 copay, all with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
HumanaChoice H7617-040 (PPO) preventive services are partially covered with no copay and no coinsurance for services such as annual physical exams, kidney disease education, glaucoma screenings, and a memory fitness benefit. However, many supplemental benefits, including health education, weight management, nutritional benefits, and in-home safety assessments, are not covered.
Hearing Services See details
HumanaChoice H7617-040 (PPO) covers hearing services, featuring Medicare-covered exams for a $30 copay and routine exams, fittings, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with a $399 to $699 copay and no coinsurance for up to two devices yearly, excluding inner ear, outer ear, and over-the-ear models.
Vision Services See details
HumanaChoice H7617-040 (PPO) partially covers vision services, featuring eye exams with a $0 to $30 copay and covered eyewear with no copay, with no coinsurance for either service. While routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered up to annual plan limits, other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice H7617-040 (PPO) with a combined annual limit of $2,000, featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered services. Fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the HumanaChoice H7617-040 (PPO) plan with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice H7617-040 (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HumanaChoice H7617-040 (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies with a 20% 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 and coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice H7617-040 (PPO), featuring no coinsurance for diagnostic procedures with copays ranging from $0 to $175, and no copay for lab services and outpatient X-rays. Therapeutic radiological services require a minimum $45 copay and 20% coinsurance, with prior authorization required for all services.
Home Health Services See details
Home Health Services are covered by HumanaChoice H7617-040 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice H7617-040 (PPO) covers cardiac rehabilitation services with no coinsurance, though prior authorization is required. While some services are covered, specific options like standard cardiac ($20 copay), intensive cardiac ($20 copay), pulmonary ($15 copay), and SET for PAD ($20 copay) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-040 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copayment for days 1 through 20 and a $218 daily copayment for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
HumanaChoice H7617-040 (PPO) covers other services including acupuncture, over-the-counter (OTC) items, and meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture, which is limited to 25 treatments per year, and the meal benefit, while OTC items are covered via reimbursement.
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