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HumanaChoice SNP-DE H7617-048 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H7617-048 (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 H7617-048 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice SNP-DE H7617-048 (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 Pennsylvania. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice SNP-DE H7617-048 (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 H7617-048 (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.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HumanaChoice SNP-DE H7617-048 (PPO D-SNP).
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 SNP-DE H7617-048 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $11.50. 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 SNP-DE H7617-048 (PPO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when filling one-month or three-month prescriptions at standard pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, copays range from $10 to $30 for Tier 1 and $20 to $60 for Tier 2 depending on the supply. For Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% cost share applies to standard pharmacies, preferred mail order, and standard mail order services. While the coinsurance for Tier 3 and Tier 4 covers both one-month and three-month supplies, Tier 5 specialty drugs are limited to a one-month supply at the same 25% rate.
Additional Benefits
The HumanaChoice SNP-DE H7617-048 (PPO D-SNP) plan offers comprehensive medical coverage with varying cost-sharing requirements depending on the service. For inpatient hospital stays, members pay a copay of $2,230 for acute care or $2,080 for psychiatric care with no coinsurance, while emergency room visits carry a $115 copay. Outpatient services, primary care, and specialist visits generally require no copay but are subject to a 20% coinsurance. Preventive care, home health services, and routine dental and vision benefits are highly accessible, often requiring no copay and no coinsurance up to specified annual limits. Skilled nursing facility stays feature no copay for the first 20 days, and diagnostic lab services along with over-the-counter items are also covered with no copay. Many of these services require prior authorization, ensuring coordinated care for plan members.
Inpatient Hospital See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) partially covers inpatient hospital services, requiring prior authorization and no coinsurance for all covered stays. Medicare-covered acute stays require a $2,230 copay per stay with unlimited additional days, while psychiatric stays require a $2,080 copay per stay. Upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Outpatient services under HumanaChoice SNP-DE H7617-048 (PPO D-SNP) generally require prior authorization and a 20% coinsurance. Outpatient hospital and ambulatory surgical center services require a $250 copay and 20% coinsurance, while outpatient substance abuse and blood services are covered with no copay and 20% coinsurance.
Partial Hospitalization See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services under HumanaChoice SNP-DE H7617-048 (PPO D-SNP) are covered with a $330 copay and no coinsurance for both ground and air transport, subject to prior authorization. Although some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
HumanaChoice SNP-DE H7617-048 (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 are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) covers primary care, specialist, therapy, mental health, and opioid treatment services with no copay and a 20% coinsurance, though prior authorization is required for most of these services. Additional telehealth benefits are available with a $0 to $40 copay and 20% coinsurance, while podiatry, routine chiropractic, and other chiropractic services are not covered.
Preventive Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) offers partially covered preventive services with no copay and no coinsurance for covered services like annual physicals, kidney disease education, glaucoma screenings, and smoking cessation. Uncovered sub-services include health education, fitness benefits, PERS, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, remote access, bathroom safety, and counseling.
Hearing Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) hearing services are partially covered with no deductible and no copays for routine exams, fitting evaluations, OTC hearing aids, and covered prescription hearing aids. Routine hearing exams require a 20% coinsurance, while fitting evaluations, OTC hearing aids, and up to two prescription hearing aids every three years have no coinsurance; however, inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by HumanaChoice SNP-DE H7617-048 (PPO D-SNP), featuring one routine eye exam per year with no copay and 20% coinsurance up to a $75 annual limit. Covered eyewear, including one annual pair of eyeglasses or contact lenses, has no copay and no coinsurance up to a $200 yearly limit, though individual lenses, frames, upgrades, and other eye exams are not covered.
Dental Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) features partially covered dental services, providing Medicare dental care with no copay and 20% coinsurance, and other covered dental benefits with no copay and no coinsurance up to a $1,000 annual limit. Non-covered services include fluoride treatment, endodontics, removable and fixed prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) covers Home Infusion bundled Services with prior authorization, featuring 0% (no coinsurance) to 20% coinsurance for chemotherapy, radiation, insulin, and other Part B drugs. Part B insulin requires a $35 copay, other Part B drugs have no copay, and step therapy may apply.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice SNP-DE H7617-048 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) covers diagnostic and radiological services with prior authorization and a 20% coinsurance. Lab services have no copay, outpatient X-rays cost a $40 copay, diagnostic tests range from no copay to $40, and diagnostic radiological services require a minimum $200 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice SNP-DE H7617-048 (PPO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice SNP-DE H7617-048 (PPO D-SNP) indicates some services are covered under its Cardiac Rehabilitation benefit with no copay and prior authorization required. However, standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for PAD are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice SNP-DE H7617-048 (PPO D-SNP) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 to 20 and a $218 copay for days 21 to 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
HumanaChoice SNP-DE H7617-048 (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, though prior authorization is required for meals and acupuncture, and some other supplemental services are not covered.
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