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HumanaChoice - Diabetes and Heart (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice - Diabetes and Heart (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice - Diabetes and Heart (PPO C-SNP) in 2026, please refer to our full plan details page.
HumanaChoice - Diabetes and Heart (PPO C-SNP) is a PPO C-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Arkansas. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice - Diabetes and Heart (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice - Diabetes and Heart (PPO C-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 - Diabetes and Heart (PPO C-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 - Diabetes and Heart (PPO C-SNP), 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 $1.00. 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 $9800.00 (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 $9800.00 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 - Diabetes and Heart (PPO C-SNP)
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Drug Coverage
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615. During the initial coverage phase, Tier 1 preferred generics require a $9 copay at standard pharmacies and preferred mail, while Tier 2 standard generics have a $47 copay. Tier 3 preferred brands and Tier 4 non-preferred drugs require 47% and 25% coinsurance respectively, while Tier 5 specialty drugs have no copay. Once your annual out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Individuals who qualify for the low-income subsidy (Extra Help) will also benefit from a $0 Part D cost.
Additional Benefits
The HumanaChoice - Diabetes and Heart (PPO C-SNP) plan offers robust coverage with no copay and no coinsurance for primary care doctor visits, standard preventive services, and home health care. For inpatient hospital stays, members are responsible for a $295 daily copay for days one through six, followed by no copay for days seven through ninety. Emergency care is available with a $130 copay, while urgently needed services require a $50 copay, both featuring no coinsurance. Supplemental benefits include routine vision exams, corrective eyewear, and over-the-counter hearing aids with no copay. Dental care is also highly accessible, featuring no copay up to a $1,250 annual limit for covered services. Additionally, the plan covers up to 26 one-way transportation trips to approved locations with no copay, while specialized services like dialysis and durable medical equipment require a 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), requiring a $295 daily copay for days 1 through 6, no copay for days 7 through 90, and no coinsurance. While unlimited additional acute care days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers outpatient services with no coinsurance and copays that vary by service. There is no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital services cost $0 to $250, observation services cost $295 per stay, and outpatient substance abuse sessions cost $30 to $35.
Partial Hospitalization See details
Partial hospitalization benefits are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with a $35 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation benefits are partially covered, providing up to 26 one-way trips to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance. Worldwide emergency, urgent care, and emergency transportation are also covered under this plan with a $130 copay and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), featuring no copay and no coinsurance for primary care provider visits. Other covered services, such as specialist and therapy visits, require copays ranging from $15 to $50 with no coinsurance, while podiatry services and routine chiropractic care are not covered.
Preventive Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers standard Medicare preventive services, annual physical exams, kidney disease education, and select screenings with no copays and no coinsurance. Additional preventive benefits are only partially covered, providing a memory fitness benefit with no copay or coinsurance, while sub-services such as health education, weight management, and nutritional counseling are not covered.
Hearing Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers hearing exams for a $15 copay and over-the-counter hearing aids with no copay, both with no coinsurance. Prescription hearing aids are partially covered with a copay between $299 and $899 and no coinsurance, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), as eyeglass lenses, eyeglass frames, and upgrades are not covered. Covered routine eye exams, contact lenses, and eyeglasses (lenses and frames) have no copay and no coinsurance, while other eye exams require a copay of $0 to $15 and no coinsurance.
Dental Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers dental services, with covered Medicare dental services requiring a $15 copay and no coinsurance, and other covered dental services having no copay and no coinsurance up to a $1,250 annual limit. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Home Infusion bundled Services with prior authorization, featuring no copay and coinsurance ranging from no coinsurance to 20% for chemotherapy, radiation, and other Part B drugs. Covered Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by HumanaChoice - Diabetes and Heart (PPO C-SNP), including durable medical equipment, prosthetic devices, medical supplies, and diabetic equipment. These services require prior authorization and generally carry a 20% coinsurance with no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with prior authorization, featuring no copay or coinsurance for lab services and outpatient X-rays. Other diagnostic procedures have copays up to $100 with no coinsurance, while radiological services range from no copay up to a $360 copay, with therapeutic radiology requiring a $40 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered by HumanaChoice - Diabetes and Heart (PPO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HumanaChoice - Diabetes and Heart (PPO C-SNP) plan, including pulmonary, intensive cardiac, and SET for PAD services. Members are responsible for the full cost of these services, as no copay or coinsurance is provided by the plan.
Skilled Nursing Facility (SNF) See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) partially covers Skilled Nursing Facility (SNF) services, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100, with no coinsurance. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice - Diabetes and Heart (PPO C-SNP) provides partially covered other services, as Dual Eligible SNPs with Highly Integrated Services are not covered. Covered benefits include acupuncture for a $15 copay and no coinsurance, alongside over-the-counter items and meal benefits with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
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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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