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Humana Full Access H7617-069 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Full Access H7617-069 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Full Access H7617-069 (PPO) in 2026, please refer to our full plan details page.
Humana Full Access H7617-069 (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 Humana Full Access H7617-069 (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 Full Access H7617-069 (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 Full Access H7617-069 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $64.00. 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 has a $250.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 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 $3400.00 (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 $3400.00 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 Full Access H7617-069 (PPO) Medicare plan features an annual prescription drug deductible of $615. 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 an $8 copay for a 1-month supply at standard pharmacies and preferred mail order, though there is no copay for a 3-month supply when filled via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across standard pharmacies and mail order options. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply. Choosing standard mail order for lower-tier generics increases your out-of-pocket costs, with copays reaching up to $30 for Tier 1 and $60 for Tier 2 three-month supplies.
Additional Benefits
The Humana Full Access H7617-069 (PPO) plan offers robust coverage with no deductible for core medical services, featuring no copay and no coinsurance for primary care visits and routine preventive care. Specialist visits require a $40 copay, while inpatient hospital stays have no coinsurance and a $325 daily copay for the first six days. Outpatient services are highly affordable, offering no copay for ambulatory surgical centers and variable copays up to $325 for outpatient hospital visits with no coinsurance. This plan also includes key supplemental benefits like routine vision exams and eyewear with no copay, alongside dental coverage featuring no copay for most services up to a $1,000 annual limit. Routine hearing exams are available with no copay, and prescription hearing aids are covered with copays ranging from $699 to $999. Additionally, home health services are fully covered with no copay, and durable medical equipment is accessible with a 15% coinsurance and no copay.
Inpatient Hospital See details
Humana Full Access H7617-069 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute days are covered at no copay, but the benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Full Access H7617-069 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services, a $0 to $325 copay for outpatient hospital and observation services, and a $25 to $35 copay for outpatient substance abuse sessions. Prior authorization is required for these covered services, which do not require a deductible.
Partial Hospitalization See details
Partial hospitalization services are covered by Humana Full Access H7617-069 (PPO) with a $35 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by Humana Full Access H7617-069 (PPO) with a $335 copay for ground transport and a $630 copay for air transport, with no coinsurance and prior authorization required. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Humana Full Access H7617-069 (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 $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Full Access H7617-069 (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $30 copay and no coinsurance, while mental health and psychiatric services require a $25 copay and no coinsurance. Chiropractic services are not covered in practice, but telehealth is available with no copay to a $65 copay and no coinsurance.
Preventive Services See details
Humana Full Access H7617-069 (PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered with no copay or coinsurance for memory fitness and smoking cessation counseling, though sub-services such as health education, in-home safety assessments, weight management, and alternative therapies are not covered.
Hearing Services See details
Hearing Services under Humana Full Access H7617-069 (PPO) are partially covered, offering Medicare-covered exams for a $40 copay and routine exams or fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to two per year with a $699 to $999 copay and no coinsurance, though OTC hearing aids alongside inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Humana Full Access H7617-069 (PPO) partially covers Vision Services with no deductible, no coinsurance, a copay ranging from no copay to $40 for eye exams, and no copay for eyewear. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Full Access H7617-069 (PPO) offers partially covered dental services with a $1,000 annual maximum for both in-network and out-of-network care. Medicare-covered dental has a $40 copay and no coinsurance, while most other covered services have no copay and no coinsurance, except for removable and fixed prosthodontics which have a 30% coinsurance and no copay. Fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Humana Full Access H7617-069 (PPO) plan with no copay, though prior authorization is required. Part B drugs for these services, including chemotherapy and other drugs, incur a coinsurance of 0% to 20%, while insulin carries a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Full Access H7617-069 (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Full Access H7617-069 (PPO) covers durable medical equipment and medical supplies with a 15% coinsurance and no copay, and prosthetic devices with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Full Access H7617-069 (PPO) covers diagnostic and radiological services, offering lab services and outpatient X-rays with no copay. Diagnostic procedures and tests have no coinsurance and a copay ranging from no copay to $100, while therapeutic radiological services require a minimum $20 copay and a minimum 20% coinsurance.
Home Health Services See details
Humana Full Access H7617-069 (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Full Access H7617-069 (PPO) covers some cardiac rehabilitation services with no coinsurance, but in practice, sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Humana Full Access H7617-069 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day hospital stay, though prior authorization is needed. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Humana Full Access H7617-069 (PPO) partially covers other services, offering acupuncture for a $40 copay and no coinsurance for up to 20 treatments yearly, as well as a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit.
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