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HumanaChoice H7617-068 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-068 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-068 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-068 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Albuquerque. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-068 (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 H7617-068 (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 H7617-068 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $9.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $200.00 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 $10100.00 (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 $10100.00 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 H7617-068 (PPO) plan features an annual drug deductible of $200. For Tier 1 preferred generic drugs, you pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost an $8 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply across standard pharmacies and mail order options, though you can save on a 3-month supply via preferred mail order for a $94 copay. Higher-tier medications require coinsurance instead of flat copays, with Tier 4 non-preferred drugs requiring 48% coinsurance and Tier 5 specialty drugs requiring 30% coinsurance.
Additional Benefits
The HumanaChoice H7617-068 (PPO) plan provides comprehensive medical coverage, featuring no copay for primary care physician visits and routine preventive screenings. If you require hospital care, inpatient stays have a $325 daily copay for the first six days followed by no copay, while emergency room visits have a $115 copay. Specialist visits require a $30 copay, and outpatient services range from no copay up to a $325 copay. Beyond standard medical care, this plan covers essential dental, vision, and hearing services, including a $2,000 annual dental benefit with no copay for most preventive care. Routine eye and hearing exams are available with no copay, alongside a $300 annual limit for eyewear and coverage for prescription hearing aids. Members also enjoy no copays for home health services, over-the-counter items, and chronic illness meal benefits.
Inpatient Hospital See details
HumanaChoice H7617-068 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance and a daily copay of $325 for days 1 through 6, followed by no copay for days 7 through 90. Unlimited additional days are covered with no copay for acute care, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice H7617-068 (PPO) offers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which also require no copay. Outpatient hospital services have a copay of $0 to $325 (with observation services at $325 per stay), and outpatient substance abuse sessions require a $25 to $35 copay.
Partial Hospitalization See details
HumanaChoice H7617-068 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
HumanaChoice H7617-068 (PPO) covers ambulance services with no coinsurance, requiring a $335 copay for ground ambulance and a $630 copay for air ambulance. Although some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
HumanaChoice H7617-068 (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 $50 copay with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-068 (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits and therapy services require a $30 copay and no coinsurance. Additional benefits like mental health, podiatry, and opioid treatment feature copays ranging from $25 to $35 with no coinsurance, though chiropractic care is only partially covered as other chiropractic services are not covered.
Preventive Services See details
HumanaChoice H7617-068 (PPO) preventive services are partially covered, featuring no copay and no coinsurance for annual physicals, kidney disease education, and other routine screenings. However, additional preventive services such as fitness benefits, health education, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
HumanaChoice H7617-068 (PPO) covers hearing services with no deductibles, offering Medicare-covered exams for a $30 copay and no coinsurance, and routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $499 to $1099 for up to two devices per year, though inner ear, outer ear, and over the ear types are not covered. Over-the-counter (OTC) hearing aids are covered with no copay and no coinsurance.
Vision Services See details
HumanaChoice H7617-068 (PPO) offers partially covered vision services with no deductibles and no coinsurance, including routine eye exams with no copay and eyewear with no copay up to a $300 annual limit. Other eye exams, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice H7617-068 (PPO), which features an annual maximum benefit of $2,000 for in- and out-of-network care. Medicare-covered dental has a $30 copay and no coinsurance, while most covered preventive and comprehensive services have no copay and no coinsurance, except for prosthodontics which requires a 30% coinsurance and no copay. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-068 (PPO) covers Home Infusion bundled Services with no copay, subject to prior authorization. Covered Medicare Part B drugs, such as insulin and chemotherapy, require copays ranging from no copay to $35 and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by HumanaChoice H7617-068 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
HumanaChoice H7617-068 (PPO) covers medical equipment with prior authorization required, including durable medical equipment (DME) at a 15% coinsurance and no copay. Prosthetic devices require a 20% coinsurance and no copay, medical supplies have a 15% coinsurance and no copay, and diabetic supplies range from 10% to 20% coinsurance with no copay, while diabetic therapeutic shoes or inserts have a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-068 (PPO) covers diagnostic and radiological services with prior authorization, offering lab services and diagnostic radiology with no copay. Diagnostic tests range from no copay to a $100 copay with no coinsurance, while therapeutic radiology requires a minimum $40 copay and 20% coinsurance, and outpatient X-rays have no copay but require coinsurance.
Home Health Services See details
Home Health Services are covered by HumanaChoice H7617-068 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice H7617-068 (PPO) with no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered, which otherwise feature copays ranging from no copay up to $20.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-068 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
HumanaChoice H7617-068 (PPO) covers acupuncture, over-the-counter (OTC) items, and meal benefits under its other services benefit. Acupuncture is covered with a $30.00 copay and no coinsurance for up to 20 treatments per year, while OTC items and chronic illness meal benefits are available with no copay and no coinsurance.
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