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HumanaChoice H7617-070 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-070 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-070 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-070 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Clark and Nye Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-070 (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 H7617-070 (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 H7617-070 (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 $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 $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 $8950.00 (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 $8950.00 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 H7617-070 (PPO) Medicare plan has an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for a one-month or three-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also budget-friendly, costing a $5 copay for a one-month supply, or no copay for a three-month supply filled via preferred mail order. For brand-name and specialty medications, costs vary depending on the drug tier and pharmacy choice. Tier 3 preferred brand drugs carry a $47 copay for a one-month supply, which can be reduced to $94 for a three-month supply using preferred mail order. Tier 4 non-preferred drugs require a 39% coinsurance, while Tier 5 specialty drugs have a 25% coinsurance across standard pharmacies and mail order options.
Additional Benefits
The HumanaChoice H7617-070 (PPO) plan offers robust medical coverage, featuring no copay for primary care physician visits, home health services, and covered preventive care. For inpatient hospital stays, members pay a $350 daily copay for days 1 through 5 and no copay for days 6 and beyond, with no coinsurance required. Outpatient hospital services range from no copay up to a $295 copay, while emergency room visits carry a $130 copay that is waived if you are admitted. Supplemental benefits include dental, vision, and hearing coverage, highlighted by no copay for routine eye exams, routine hearing exams, and preventive dental care under a $2,500 annual limit. For specialized needs, durable medical equipment and dialysis services require a 20% coinsurance with no copay, while skilled nursing facility stays require a $10 daily copay for the first 20 days. However, certain services such as routine transportation and cardiac rehabilitation are not covered by this plan.
Inpatient Hospital See details
Inpatient hospital services are covered by HumanaChoice H7617-070 (PPO) with no coinsurance, requiring a $350 daily copay for days 1 to 5 and no copay for days 6 and beyond for acute stays. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-070 (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $295 copay and observation services with a $350 copay per stay. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $25 to $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HumanaChoice H7617-070 (PPO) with a $35.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by HumanaChoice H7617-070 (PPO), which features no coinsurance for ambulance services but does not cover transportation services to plan-approved or any health-related locations. Covered ground ambulance services require a $335 copay and air ambulance services require a $630 copay, with prior authorization required for both.
Emergency Services See details
HumanaChoice H7617-070 (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 and no coinsurance, and worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-070 (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Physical, occupational, and mental health therapies require a $25 copay and no coinsurance, while podiatry is not covered and chiropractic benefits cover some services but exclude routine and other chiropractic care.
Preventive Services See details
HumanaChoice H7617-070 (PPO) offers partially covered preventive services with no copays and no coinsurance for covered options, including annual physical exams, kidney disease education, select screenings, and memory fitness. However, several additional services are not covered, including health education, in-home safety assessments, nutritional/dietary benefits, and weight management programs.
Hearing Services See details
HumanaChoice H7617-070 (PPO) covers hearing services, including routine exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance, while Medicare-covered exams require a $30 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $699 to $999 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 H7617-070 (PPO) vision services are partially covered with no coinsurance, featuring no copay for annual routine eye exams and covered eyewear up to a $300 yearly limit. Prior authorization is required, and other eye exams, separate eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-070 (PPO) offers partially covered dental services with a $2,500 annual maximum, featuring no copay and no coinsurance for preventive care and most comprehensive services, while prosthodontics require no copay and 30% coinsurance, and Medicare-covered dental has a $30 copay and no coinsurance. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-070 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance up to 20%, with insulin drugs also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by HumanaChoice H7617-070 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice H7617-070 (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 and inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-070 (PPO) covers diagnostic and radiological services, featuring no copay for lab and outpatient X-ray services, and no coinsurance for diagnostic tests. Outpatient diagnostic procedures and tests have a copay ranging from $0 to $85, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
HumanaChoice H7617-070 (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the HumanaChoice H7617-070 (PPO) plan, as sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are all not covered. Although the plan technically features no coinsurance, patients will not have coverage for any of these rehabilitation services.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-070 (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 additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
HumanaChoice H7617-070 (PPO) partially covers other services, including acupuncture, over-the-counter (OTC) items, and meal benefits, while excluding other additional services. Acupuncture requires a $30 copay and no coinsurance, while OTC items and meal benefits are available with no copay and no coinsurance.
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