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HumanaChoice SNP-DE H7617-076 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H7617-076 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice SNP-DE H7617-076 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Oklahoma. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice SNP-DE H7617-076 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice SNP-DE H7617-076 (PPO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HumanaChoice SNP-DE H7617-076 (PPO D-SNP).
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 SNP-DE H7617-076 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.20. 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 $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 $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.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for HumanaChoice SNP-DE H7617-076 (PPO D-SNP)
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Drug Coverage
The HumanaChoice SNP-DE H7617-076 (PPO D-SNP) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay for 1-month or 3-month supplies at standard pharmacies and through preferred mail order. If you use standard mail order, Tier 1 drugs have a $10 to $30 copay and Tier 2 drugs have a $20 to $60 copay depending on the supply. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies across standard pharmacies, preferred mail order, and standard mail order options. Note that Tier 5 specialty drugs are restricted to a 1-month supply, while Tiers 3 and 4 are available in both 1-month and 3-month supplies.
Additional Benefits
The HumanaChoice SNP-DE H7617-076 (PPO D-SNP) plan offers broad medical coverage, though many outpatient services, primary care visits, and durable medical equipment require a 20% coinsurance with no copay. Inpatient hospital stays require a copayment of $2,230 per acute stay and $2,080 per psychiatric stay, while emergency services carry a $115 copay that is waived upon hospital admission. Routine preventive services and home health care are fully covered with no copay and no coinsurance. For specialty care, the plan provides dental benefits up to a $2,500 annual limit and eyewear up to a $450 yearly limit with no copay and no coinsurance. Members also benefit from covered hearing aids, over-the-counter items, and up to 36 one-way transportation trips per year to plan-approved locations with no copay. Skilled nursing facility care is covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) inpatient hospital benefits are partially covered, requiring a $2,230 copayment per acute stay and a $2,080 copayment per psychiatric stay with no coinsurance for either. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services under the HumanaChoice SNP-DE H7617-076 (PPO D-SNP) plan are covered with no copay, but most care requires a 20% coinsurance and prior authorization. This includes outpatient hospital visits, ambulatory surgical center services, outpatient substance abuse therapy, and outpatient blood services.
Partial Hospitalization See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services require a $115 copay with no coinsurance.
Primary Care See details
Primary care services are partially covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP), offering covered services such as doctor visits, mental health, and therapy with no copay and a 20% coinsurance. Podiatry and chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered under the HumanaChoice SNP-DE H7617-076 (PPO D-SNP) plan with no copay and no coinsurance for covered care such as annual physicals, kidney disease education, and memory fitness. The plan does not cover health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, or counseling.
Hearing Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers annual routine hearing exams with a 20% coinsurance and no copay, as well as unlimited hearing aid fittings and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every three years, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) features partially covered vision services, including routine eye exams with no copay and 20% coinsurance up to a $40 annual limit. Eyewear is also partially covered with no copay and no coinsurance up to a $450 yearly limit for contact lenses and eyeglasses, while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) offers partially covered dental services, including Medicare-covered dental with no copay and 20% coinsurance, alongside preventive and comprehensive benefits with no copay and no coinsurance up to a $2,500 annual limit. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers home infusion bundled services with prior authorization, requiring a $35 copay and 0% to 20% coinsurance for Medicare Part B insulin. Covered chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance, with no copay charged for other Part B drugs.
Dialysis Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment with no copays. A 20% coinsurance applies to DME, prosthetic devices, medical supplies, and diabetic supplies, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP) with a 20% coinsurance for all services, subject to prior authorization. Outpatient X-rays require a $50 copay, diagnostic radiological services require a copay, and diagnostic procedures, tests, and lab services are offered with no copay.
Home Health Services See details
Home Health Services are covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice SNP-DE H7617-076 (PPO D-SNP) with no copay, though prior authorization is required. However, specific sub-services—including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation—are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
HumanaChoice SNP-DE H7617-076 (PPO D-SNP) partially covers other services, including acupuncture with no copay and a 20% coinsurance for up to 20 treatments yearly. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for some services and other specific benefits are not covered.
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