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HumanaChoice H7617-059 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-059 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-059 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-059 (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 H7617-059 (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 H7617-059 (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 H7617-059 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.00. 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 $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 H7617-059 (PPO) Medicare prescription drug plan features an annual drug deductible of $420. For Tier 1 preferred generic drugs, members 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 at standard pharmacies, with no copay for a 3-month supply filled through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, with savings available on 3-month supplies through preferred mail order for a $131 copay. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 48% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply. Understanding these copays and coinsurance rates helps you maximize your prescription savings under this HumanaChoice PPO plan.
Additional Benefits
The HumanaChoice H7617-059 (PPO) plan offers robust medical coverage with no copay or coinsurance for primary care visits, home health services, and Medicare-covered preventive care. For specialist visits, emergency care, and urgent care, members pay fixed copays of $40, $115, and $40, respectively, with no coinsurance. Inpatient hospital stays require a daily copay of $345 for days 1 through 6, while outpatient services range from no copay for ambulatory surgical centers to a copay of up to $350 for hospital outpatient services. This plan also includes supplemental benefits, featuring no copay and no coinsurance for routine hearing exams, routine vision exams up to a $75 limit, and preventive dental services up to a $1,000 annual limit. Prescription hearing aids require a copay of $699 to $999, while durable medical equipment is covered with a 15% coinsurance and no copay. Additionally, over-the-counter items and home-delivered meals are available with no copay and no coinsurance.
Inpatient Hospital See details
HumanaChoice H7617-059 (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a daily copay of $345 for days 1 through 6 of acute stays and $335 for days 1 through 6 of psychiatric stays, with no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
Outpatient services are covered by HumanaChoice H7617-059 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $350, observation services have a $345 copay per stay, and outpatient substance abuse sessions carry a copay of $30 to $35.
Partial Hospitalization See details
Partial hospitalization services are covered by HumanaChoice H7617-059 (PPO) for a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HumanaChoice H7617-059 (PPO), with ground ambulance services requiring a $335 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and while some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HumanaChoice H7617-059 (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-059 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits carry a $40 copay and therapy services cost a $25 copay with no coinsurance. Mental health, psychiatric, and telehealth services feature copays up to $40 with no coinsurance, whereas podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
HumanaChoice H7617-059 (PPO) covers Medicare-covered preventive services, annual physical exams, kidney disease education, and select screenings with no copay and no coinsurance. While a memory fitness benefit is included, other supplemental services like health education, nutritional benefits, and in-home safety assessments are not covered.
Hearing Services See details
HumanaChoice H7617-059 (PPO) covers hearing services with no coinsurance, featuring no copay for annual routine exams, unlimited fitting evaluations, and OTC hearing aids, alongside a $40 copay for Medicare-covered exams. Prescription hearing aids are partially covered with a $699 to $999 copay and no coinsurance for up to two devices per year, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HumanaChoice H7617-059 (PPO) offers vision services with no deductible, featuring one routine eye exam per year with no copay and no coinsurance up to a $75 limit. Eyewear is partially covered with no copay and no coinsurance up to a $150 annual maximum for contact lenses and eyeglasses, though individual lenses, frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-059 (PPO) dental services are partially covered, featuring no copay and no coinsurance for preventive and most comprehensive services up to a $1,000 annual limit, while Medicare-covered dental services require a $40 copay and no coinsurance. Fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-059 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance up to 20%, while covered Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice H7617-059 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
HumanaChoice H7617-059 (PPO) covers durable medical equipment (DME) with a 15% 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 or inserts require a $10 copay and applicable coinsurance, subject to prior authorization and manufacturer limits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the HumanaChoice H7617-059 (PPO) plan, with prior authorization required. Members pay no copay for lab services, outpatient X-rays, and diagnostic radiology, while diagnostic procedures have no coinsurance and a copay up to $175, and therapeutic radiological services require a 20% coinsurance and a minimum $45 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-059 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered under the HumanaChoice H7617-059 (PPO) plan with no coinsurance, and while some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-059 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
HumanaChoice H7617-059 (PPO) covers other services including acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, alongside meal benefits and over-the-counter items with no copay and no coinsurance. Prior authorization is required for acupuncture and meal benefits, and certain other miscellaneous services are not covered.
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