Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Giveback H7617-065 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Giveback H7617-065 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice Giveback H7617-065 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in West Virginia. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Giveback H7617-065 (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Below are a few key facts and commonly-asked questions about HumanaChoice Giveback H7617-065 (PPO).
The cost of a Medicare Advantage Plan is made up of four main parts.
For HumanaChoice Giveback H7617-065 (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 $119.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $590.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $325.00 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.
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The HumanaChoice Giveback H7617-065 (PPO) plan features an annual drug deductible of $325. For Tier 1 preferred generic drugs, there is no copay for a one-month or three-month supply at standard pharmacies and through preferred mail order, while standard mail order costs up to $30 for a three-month supply. Tier 2 generic drugs are also highly affordable, costing a $1 copay for a one-month supply at standard pharmacies or preferred mail order, and there is no copay for a three-month supply filled via preferred mail order. For Tier 3 preferred brand drugs, you will pay a $30 copay for a one-month supply at standard pharmacies and preferred mail order, whereas standard mail order costs $47. Higher-tier prescriptions require coinsurance rather than flat copays, with Tier 4 non-preferred drugs requiring a 45% coinsurance across all pharmacy options. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply at standard pharmacies, preferred mail order, and standard mail order.
The HumanaChoice Giveback H7617-065 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, routine preventive services, home health care, and annual eye exams. For other essential medical needs, specialist visits require a $45 copay, emergency room care has a $115 copay, and inpatient hospital stays carry a $400 daily copay for the first few days with no coinsurance. Outpatient services generally feature no coinsurance, with copays ranging from no copay to $400 depending on the facility. This plan also provides valuable supplemental benefits, including dental coverage up to $1,500 per year with no copay or coinsurance for most preventive and comprehensive services. Hearing care features no copay for routine exams alongside fixed copays for prescription hearing aids, while routine eyewear is covered with no copay. Diagnostic lab work and X-rays also carry no copay, while durable medical equipment and prosthetics require no copay but carry a 15% to 20% coinsurance.
Inpatient hospital services are covered by HumanaChoice Giveback H7617-065 (PPO) with no coinsurance, requiring a $400 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
HumanaChoice Giveback H7617-065 (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services, and copays ranging from $0 to $400 for outpatient hospital and observation services. Outpatient substance abuse services require a $35 copay with no coinsurance, and prior authorization is required for most of these covered outpatient benefits.
HumanaChoice Giveback H7617-065 (PPO) covers partial hospitalization benefits with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
HumanaChoice Giveback H7617-065 (PPO) covers Medicare-covered ground and air ambulance services with a $335 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, trips to plan-approved health-related locations or any health-related locations are not covered.
Emergency services under the HumanaChoice Giveback H7617-065 (PPO) plan are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation are all covered with a $115 copay and no coinsurance.
HumanaChoice Giveback H7617-065 (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Additional services like therapy, mental health, and telehealth feature copays ranging from no copay to $45 with no coinsurance, though podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic care are not.
HumanaChoice Giveback H7617-065 (PPO) covers preventive services, including annual physical exams, kidney disease education, and diabetes screenings, with no copay and no coinsurance. While a memory fitness benefit is covered with no copay, other supplemental services like health education, in-home safety assessments, and nutritional therapy are not covered.
HumanaChoice Giveback H7617-065 (PPO) covers hearing services, including Medicare-covered exams for a $45 copay and routine exams or fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $699 to $999, though OTC, inner-ear, outer-ear, and over-the-ear hearing aids are not covered.
HumanaChoice Giveback H7617-065 (PPO) provides partially covered vision services with no deductibles and no coinsurance, including one routine eye exam and eyewear (contact lenses or eyeglasses) per year with no copay. Other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
HumanaChoice Giveback H7617-065 (PPO) partially covers dental services up to an annual maximum of $1,500, offering no copay and no coinsurance for most covered preventive and comprehensive services, while Medicare-covered dental has a $45 copay and no coinsurance. Fixed prosthodontics require no copay and a 30% coinsurance, but fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled services are covered by HumanaChoice Giveback H7617-065 (PPO) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services are covered by HumanaChoice Giveback H7617-065 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
HumanaChoice Giveback H7617-065 (PPO) covers durable medical equipment (DME) with a 15% coinsurance and no copay, and prosthetic devices 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.
HumanaChoice Giveback H7617-065 (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $100 copay, while radiological services range from no copay for X-rays and diagnostic radiology to a minimum $50 copay and 20% coinsurance for therapeutic radiology.
HumanaChoice Giveback H7617-065 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
HumanaChoice Giveback H7617-065 (PPO) does not cover cardiac rehabilitation services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
HumanaChoice Giveback H7617-065 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copayment for days 1 through 20 and a $218 copayment for days 21 through 100. Prior authorization is required, admission does not require a prior three-day inpatient hospital stay, and additional days beyond the standard Medicare-covered limit are not covered.
HumanaChoice Giveback H7617-065 (PPO) partially covers other services, offering acupuncture with a $45 copay and no coinsurance for up to 20 treatments per year, and a meal benefit for homebound medical conditions with no copay and no coinsurance. Over-the-counter items and other additional services are not covered under this plan.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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