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HumanaChoice H7617-063 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-063 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-063 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-063 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in El Paso County. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-063 (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 H7617-063 (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 H7617-063 (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 $340.00 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 $9550.00 (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 $9550.00 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 H7617-063 (PPO) Medicare prescription drug plan features an annual drug deductible of $340. Tier 1 preferred generic drugs are highly affordable, offering no copay for one-month and three-month supplies at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost a $9 copay for a one-month supply at standard pharmacies and preferred mail order, and you can enjoy no copay for a three-month supply when using preferred mail order. For Tier 3 preferred brand drugs, you will pay a $45 copay for a one-month supply at standard pharmacies and preferred mail order, or up to a $141 copay for a three-month standard mail order. Higher-tier medications require coinsurance instead of flat copays, with Tier 4 non-preferred drugs carrying a 45% coinsurance and Tier 5 specialty drugs requiring a 29% coinsurance for a one-month supply. These structured cost-sharing tiers provide clear options for managing your prescription medication expenses under this Humana Choice PPO plan.
Additional Benefits
The HumanaChoice H7617-063 (PPO) plan offers comprehensive coverage for core medical needs, featuring no copay or coinsurance for primary care visits and preventive care. Specialist visits require a $30 copay, while inpatient hospital stays have a $245 daily copay for the first five days followed by no copay for additional days. Emergency care is covered with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. Beneficiaries also enjoy valuable supplemental benefits, including no copays for routine dental, vision, and hearing exams, alongside allowances of up to $2,500 for dental care and $300 for eyewear. Additionally, the plan covers home health services and up to 48 one-way routine transportation trips with no copay, while durable medical equipment and dialysis services are subject to a 20% coinsurance.
Inpatient Hospital See details
HumanaChoice H7617-063 (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $245 daily copay for days 1 through 5 and no copay for days 6 through 90 for acute and psychiatric stays. Unlimited additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-063 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services range from no copay to a $275 copay, while outpatient substance abuse sessions require a $30 to $35 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by HumanaChoice H7617-063 (PPO) with a $35 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under HumanaChoice H7617-063 (PPO), with ground ambulance requiring a $335 copay (no coinsurance) and air ambulance requiring a 20% coinsurance (no copay). Transportation is partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice H7617-063 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are all covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-063 (PPO) covers primary care physician services with no copay and no coinsurance, alongside telehealth benefits ranging from a $0 to $50 copay with no coinsurance. Specialist visits, physical, occupational, speech, psychiatric, and mental health services require a $30 copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
HumanaChoice H7617-063 (PPO) covers preventive services, including annual physical exams, kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, EKGs, and a memory fitness benefit with no copays and no coinsurance. However, many supplemental preventive services, such as health education, weight management, nutritional benefits, and in-home safety assessments, are not covered.
Hearing Services See details
HumanaChoice H7617-063 (PPO) covers hearing services with no deductible, offering routine exams and fitting evaluations for no copay or coinsurance, and Medicare-covered exams for a $30 copay and no coinsurance. Prescription hearing aids are partially covered with a $299 to $599 copay and no coinsurance—excluding inner ear, outer ear, and over the ear models—while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
Vision services are partially covered by HumanaChoice H7617-063 (PPO) with no deductible, no coinsurance, and no copays for covered benefits. One routine eye exam is covered up to $40 annually, and contact lenses or eyeglasses are covered up to $300 annually, but other eye exams, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice H7617-063 (PPO), featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for most preventive and comprehensive services up to a $2,500 annual limit. Fluoride treatments, implants, fixed prosthodontics, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-063 (PPO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs have no copay and a range of no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the HumanaChoice H7617-063 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
HumanaChoice H7617-063 (PPO) covers durable medical equipment, 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 coinsurance.
Diagnostic and Radiological Services See details
HumanaChoice H7617-063 (PPO) covers diagnostic and radiological services, with prior authorization required. Diagnostic tests have no coinsurance and a $0 to $50 copay, lab services, outpatient X-rays, and diagnostic radiology have no copay, and therapeutic radiological services require a minimum 20% coinsurance and a minimum $40 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-063 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services under HumanaChoice H7617-063 (PPO) require prior authorization and feature no coinsurance, but only some services are covered. Specifically, standard cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation (with a $20 copay), pulmonary rehabilitation (with a $15 copay), and supervised exercise therapy for peripheral artery disease (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-063 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a 3-day prior hospital stay is not needed, additional days beyond the standard 100 days are not covered.
Other Services See details
Other services covered by HumanaChoice H7617-063 (PPO) include acupuncture, over-the-counter items, and chronic illness meal benefits. Acupuncture requires a $30 copay and no coinsurance for up to 20 treatments per year, while meal benefits and over-the-counter items are available with no copay and no coinsurance.
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