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Humana Value Choice H7617-043 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-043 (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 H7617-043 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-043 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Dallas and East Texas Metro. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Value Choice H7617-043 (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 H7617-043 (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 H7617-043 (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 $1.00. 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 $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 $10100.00 (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 $10100.00 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 H7617-043 (PPO) Medicare prescription drug plan features an annual drug deductible of $420. Under this plan, Tier 1 preferred generic drugs have no copay for 1-month and 3-month supplies at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also highly accessible, with a $9 copay for a 1-month supply at standard pharmacies and no copay for a 3-month supply filled via preferred mail order. For brand-name and specialized medications, Tier 3 preferred brand drugs carry a $45 copay for a 1-month supply at standard pharmacies and preferred mail order. Tier 4 non-preferred drugs require a 48% coinsurance, while Tier 5 specialty drugs carry a 28% coinsurance across all standard pharmacy and mail-order options. This structured cost-sharing allows beneficiaries to optimize their prescription savings by utilizing preferred mail order services.
Additional Benefits
The Humana Value Choice H7617-043 (PPO) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copay or coinsurance for primary care visits and a $30 copay for specialists. If you require hospital care, inpatient stays have no coinsurance and a $310 daily copay for the first six days, while home health services are available with no copay. Emergency room visits require a $130 copay, which is waived if you are admitted, and urgent care services carry a $50 copay. This plan also includes strong supplemental benefits, offering no copay or coinsurance for annual routine physicals, fitness benefits, and most dental services up to a $2,500 annual limit. Routine vision and hearing exams also feature no copay, with allowances and partial coverage available for eyewear and prescription hearing aids. For medical needs, durable medical equipment is covered with an 18% coinsurance and no copay, making essential health supplies highly accessible.
Inpatient Hospital See details
Inpatient hospital care is covered by Humana Value Choice H7617-043 (PPO) with no coinsurance, requiring a $310 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Value Choice H7617-043 (PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $310 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions carry a $30 to $35 copay with no coinsurance.
Partial Hospitalization See details
Humana Value Choice H7617-043 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Humana Value Choice H7617-043 (PPO) covers ambulance services with a $335 copay for ground transport and a 20% coinsurance for air transport, with prior authorization required. Transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Humana Value Choice H7617-043 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services each carry a $130 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-043 (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Other services like physical therapy and mental health sessions have copays ranging from $0 to $35 with no coinsurance, although podiatry is not covered and chiropractic services are only partially covered due to the exclusion of non-routine chiropractic services.
Preventive Services See details
Preventive services are covered by Humana Value Choice H7617-043 (PPO) with no copay and no coinsurance for annual physicals, kidney disease education, fitness benefits, and select screenings. Additional preventive benefits are only partially covered, excluding 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 services, home-based 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
Hearing services under the Humana Value Choice H7617-043 (PPO) plan are covered with no deductible, featuring no copay and no coinsurance for annual routine exams, fitting evaluations, and OTC hearing aids. Medicare-covered exams require a $30 copay and no coinsurance, while prescription hearing aids are partially covered with a $199 to $499 copay and no coinsurance. Up to two prescription aids are covered per year, but inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Humana Value Choice H7617-043 (PPO) partially covers vision services, offering eye exams with a $0 to $30 copay and eyewear with no copay, both with no coinsurance or deductibles. Covered eyewear includes contact lenses and eyeglasses up to a $300 annual limit, while other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Value Choice H7617-043 (PPO) partially covers dental services up to a combined in- and out-of-network annual maximum of $2,500, featuring no copay and no coinsurance for most covered preventive and comprehensive services. Medicare-covered dental services require a $30 copay and no coinsurance, while fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Value Choice H7617-043 (PPO) with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Humana Value Choice H7617-043 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Humana Value Choice H7617-043 (PPO) covers durable medical equipment (DME) with an 18% coinsurance and no copay, and 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 have a $10 copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services under Humana Value Choice H7617-043 (PPO) are covered, featuring no copay for lab services, diagnostic radiology, and outpatient X-rays. Diagnostic procedures have a copay ranging from $0 to $175 with no coinsurance, while therapeutic radiological services require a minimum $30 copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Value Choice H7617-043 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Value Choice H7617-043 (PPO) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and carry copays ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Humana Value Choice H7617-043 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. Patients will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Value Choice H7617-043 (PPO), featuring acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year. Over-the-counter items and chronic illness meal benefits are also available with no copay and no coinsurance, although meals and acupuncture require prior authorization.
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