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Humana Value Choice H7617-057 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-057 (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 H7617-057 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-057 (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 Humana Value Choice H7617-057 (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 H7617-057 (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 H7617-057 (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 $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 $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 $11900.00 (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 $11900.00 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 H7617-057 (PPO) plan features an annual prescription drug deductible of $420. 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 medications cost as low as a $5 copay for a 1-month supply, with no copay for a 3-month supply when filled through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across standard pharmacies and mail order options. Higher-tier prescription costs transition to coinsurance, with Tier 4 non-preferred drugs requiring 48% coinsurance and Tier 5 specialty drugs requiring 28% coinsurance for a 1-month supply.
Additional Benefits
The Humana Value Choice H7617-057 (PPO) plan offers robust core medical coverage with no copay for primary care visits, preventive services, and home health care. For hospital stays, members pay a daily copay of $340 for days 1 through 6 of acute inpatient care and up to a $300 copay for outpatient hospital services, with no coinsurance required for either. Emergency care features a $115 copay, which is waived if you are admitted, while urgent care visits require a $40 copay. This plan also includes valuable supplemental benefits, featuring routine hearing and vision exams with no copay, alongside dental coverage that offers no copay for most services up to a $2,000 annual limit. Prescription hearing aids require copays ranging from $699 to $999, while over-the-counter hearing aids, meals, and select over-the-counter items are available with no copay. For medical equipment and dialysis, members can expect to pay coinsurance ranging from 10% to 20% with no copay.
Inpatient Hospital See details
Humana Value Choice H7617-057 (PPO) covers inpatient hospital services with no coinsurance, requiring a $340 daily copay for days 1 to 6 of acute stays and a $335 daily copay for days 1 to 6 of psychiatric stays, with no copay for subsequent covered days. 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 H7617-057 (PPO) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services and no copay for ambulatory surgical center or blood services. Outpatient substance abuse sessions have a $30 to $35 copay, while observation services require a $340 copay per stay, all with no coinsurance.
Partial Hospitalization See details
Humana Value Choice H7617-057 (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 H7617-057 (PPO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Humana Value Choice H7617-057 (PPO) covers emergency services with a $115 copay, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-057 (PPO) primary care benefits are partially covered, offering primary care physician visits with no copay and no coinsurance, and specialist, therapy, and mental health services with copays ranging from $15 to $40 and no coinsurance. Podiatry services and non-routine chiropractic care are not covered.
Preventive Services See details
Humana Value Choice H7617-057 (PPO) covers preventive services, including annual physical exams, kidney disease education, and select screenings with no copay and no coinsurance. Additional preventive benefits are partially covered, offering a memory fitness benefit with no copay, while services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and alternative therapies are not covered.
Hearing Services See details
Humana Value Choice H7617-057 (PPO) covers routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $30 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, excluding inner ear, outer ear, and over-the-ear prescription hearing aids, while OTC hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Humana Value Choice H7617-057 (PPO) covers vision services with no deductibles or coinsurance, featuring a $0 to $30 copay for eye exams and no copay for covered eyewear, up to annual maximums of $75 and $150. This benefit is partially covered, as other eye exam services, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Value Choice H7617-057 (PPO), featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered services up to a $2,000 annual limit. Fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Value Choice H7617-057 (PPO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other drugs are covered with no copay and ranging from no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and ranging from no coinsurance up to 20% coinsurance.
Dialysis Services See details
Humana Value Choice H7617-057 (PPO) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Value Choice H7617-057 (PPO) covers medical equipment, including durable medical equipment (DME) with an 18% coinsurance and no copay. Prosthetics and medical supplies are covered with a 20% coinsurance and no copay, while diabetic supplies require a 10% to 20% coinsurance (no copay) and diabetic therapeutic shoes or inserts carry a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Humana Value Choice H7617-057 (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $175 copay for procedures, while radiological services range from no copay for X-rays to a minimum $45 copay and 20% coinsurance for therapeutic treatments.
Home Health Services See details
Humana Value Choice H7617-057 (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Value Choice H7617-057 (PPO) with no copay and no coinsurance, although prior authorization is required. While the plan technically offers this benefit, in practice only some services are covered, and standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Value Choice H7617-057 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other Services are partially covered by Humana Value Choice H7617-057 (PPO), excluding certain miscellaneous services. Covered benefits include acupuncture for a $30 copay and no coinsurance, as well as over-the-counter items and meal benefits with no copay and no coinsurance.
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