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HumanaChoice Giveback H7617-056 (PPO)

Benefits Summary and Overview

This page is a benefits summary and overview of key plan information for HumanaChoice Giveback H7617-056 (PPO). The information on this page is a summary only.

For a complete listing of all available benefits and cost information on HumanaChoice Giveback H7617-056 (PPO) in 2026, please refer to our full plan details page.

HumanaChoice Giveback H7617-056 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Arkansas and Oklahoma. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that HumanaChoice Giveback H7617-056 (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about HumanaChoice Giveback H7617-056 (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 Giveback H7617-056 (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 $100.00. You must continue to pay paying your reduced Part B Premium.

Deductibles

This plan has a $375.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.

This plan has no drug deductible. Your prescription medication coverage will start immediately.

Out-of-Pocket Maximums

This plan has a combined Maximum Out-Of-Pocket cost of $11000.00 (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 $11000.00 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:

Regular visits to your primary care doctor are covered and will have a copay of and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of and coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for HumanaChoice Giveback H7617-056 (PPO)

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Drug Coverage IconDrug Coverage

The HumanaChoice Giveback H7617-056 (PPO) plan features an enhanced alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies and through preferred mail order, while standard mail carries a $20 copay. For Tier 2 standard generics, you will pay a $30 copay at standard pharmacies and preferred mail, or a $47 copay through standard mail. For higher-tier medications, Tier 3 preferred brands require 35% coinsurance, while Tier 4 non-preferred drugs carry 33% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Additionally, qualifying for the low-income subsidy can reduce your premium and lower your Part D costs to nothing.

Additional Benefits IconAdditional Benefits

The HumanaChoice Giveback H7617-056 (PPO) plan offers coverage for essential medical needs with no copay for primary care visits, annual physicals, and home health services. For specialized medical care, members pay no coinsurance and predictable copays, including $30 to $35 for specialist visits, $115 for emergency care, and a $360 daily copay for the first six days of an inpatient hospital stay. Outpatient hospital visits and diagnostic procedures are covered with no coinsurance and copays ranging from no copay up to $360. This plan also provides valuable supplemental benefits, offering routine dental, vision, and hearing exams with no copay and no coinsurance, subject to annual coverage limits. Prescription hearing aids require a copay of $699 to $999, while durable medical equipment and dialysis services generally require a 10% to 20% coinsurance with no copay. Additionally, skilled nursing facility stays are covered with no copay or coinsurance for the first 20 days of care.

Inpatient Hospital See details

Inpatient hospital benefits are partially covered by HumanaChoice Giveback H7617-056 (PPO) with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Medicare-covered acute stays require a $360 daily copay for days 1-6 and no copay for days 7-999, while psychiatric stays require a $318 daily copay for days 1-6 and no copay for days 7-90.

Outpatient Services See details

Outpatient services are covered by HumanaChoice Giveback H7617-056 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital visits require a copay of $0 to $360, observation services cost a $360 copay per stay, and outpatient substance abuse sessions carry a copay of $30 to $35.

Partial Hospitalization See details

HumanaChoice Giveback H7617-056 (PPO) covers partial hospitalization services with a $35 copay and no coinsurance. Prior authorization is required to receive these covered benefits.

Ambulance and Transportation Services See details

HumanaChoice Giveback H7617-056 (PPO) partially covers ambulance and transportation services, with ground ambulance requiring a $335 copay and no coinsurance, and air ambulance requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance services, while transportation services to plan-approved or any health-related locations are not covered.

Emergency Services See details

HumanaChoice Giveback H7617-056 (PPO) covers emergency services, alongside worldwide emergency, urgent, and transportation services, with a $115 copay and no coinsurance. Urgently needed services are covered with a $40 copay and no coinsurance, and the emergency copay is waived if you are admitted to the hospital within 24 hours.

Primary Care See details

HumanaChoice Giveback H7617-056 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health visits require copays ranging from $30 to $35 and no coinsurance. Additional telehealth and other healthcare professional services are available with copays up to $40, though podiatry and routine chiropractic care are not covered.

Preventive Services See details

Preventive services are covered by HumanaChoice Giveback H7617-056 (PPO) with no copay and no coinsurance for annual physicals, kidney disease education, memory fitness, and select screenings. Additional preventive services are only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, and extra smoking cessation sessions are not covered.

Hearing Services See details

Hearing services are covered by HumanaChoice Giveback H7617-056 (PPO), featuring no copay, no deductible, and no coinsurance for annual routine exams and fitting evaluations, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are partially covered with a $699 to $999 copay and no coinsurance for up to two devices per year, though over-the-counter hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.

Vision Services See details

HumanaChoice Giveback H7617-056 (PPO) partially covers vision services, excluding separate eyeglass lenses, eyeglass frames, and upgrades. Covered routine eye exams, contact lenses, and complete eyeglasses feature no copay and no coinsurance, while other eye exams require a copay of up to $35 and no coinsurance. The plan offers an annual maximum benefit of $75 for exams and a combined $200 limit for eyewear.

Dental Services See details

Dental services are partially covered by HumanaChoice Giveback H7617-056 (PPO), with no coverage for fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require a $35 copay and no coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,000 annual maximum.

Home Infusion bundled Services See details

HumanaChoice Giveback H7617-056 (PPO) covers home infusion bundled services with prior authorization, requiring no copay and coinsurance ranging from no coinsurance to 20% for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are also covered under this benefit, requiring a $35 copay and coinsurance ranging from no coinsurance to 20%.

Dialysis Services See details

Dialysis services are covered under the HumanaChoice Giveback H7617-056 (PPO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.

Medical Equipment See details

Medical equipment is covered by HumanaChoice Giveback H7617-056 (PPO), including durable medical equipment (DME) with a 10% coinsurance and no copay. Prosthetics and medical supplies require a 13% coinsurance and no copay, while diabetic supplies carry a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts have a $10 copay.

Diagnostic and Radiological Services See details

Diagnostic and radiological services are covered by HumanaChoice Giveback H7617-056 (PPO) with prior authorization, offering lab services and outpatient X-rays at no copay or coinsurance. Diagnostic procedures require a $0 to $90 copay, diagnostic radiology carries a $0 to $360 copay (both with no coinsurance), and therapeutic radiology requires a $50 copay and 20% coinsurance.

Home Health Services See details

Home health services are covered by HumanaChoice Giveback H7617-056 (PPO) with no copay and no coinsurance, although prior authorization is required.

Cardiac Rehabilitation Services See details

HumanaChoice Giveback H7617-056 (PPO) does not cover Cardiac Rehabilitation Services in practice, as Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are all not covered.

Skilled Nursing Facility (SNF) See details

HumanaChoice Giveback H7617-056 (PPO) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization and excluding coverage for additional days beyond Medicare-covered limits. For covered stays, you will pay no copay and no coinsurance for days 1 through 20, and a $218 daily copay with no coinsurance for days 21 through 100.

Other Services See details

Other services are partially covered by HumanaChoice Giveback H7617-056 (PPO), which offers acupuncture services for a $35 copay and no coinsurance, and meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items and dual eligible SNPs with highly integrated services are not covered.

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