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HumanaChoice SNP-DE H7617-084 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice SNP-DE H7617-084 (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 H7617-084 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice SNP-DE H7617-084 (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 Mississippi. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice SNP-DE H7617-084 (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 H7617-084 (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 H7617-084 (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 H7617-084 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.30. 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 H7617-084 (PPO D-SNP)
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Drug Coverage
The HumanaChoice SNP-DE H7617-084 (PPO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay for one-month and three-month supplies at standard pharmacies and through preferred mail order. If you choose standard mail order, Tier 1 and Tier 2 drugs carry a copay of $10 to $20 for a one-month 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 to standard pharmacies, preferred mail order, and standard mail order options. Specialty medications in Tier 5 are limited to a one-month supply.
Additional Benefits
The HumanaChoice SNP-DE H7617-084 (PPO D-SNP) plan offers comprehensive healthcare coverage, including preventive care and home health services with no copay and no coinsurance. Inpatient hospital stays require a set copay per stay with no coinsurance, while primary care, specialist visits, and outpatient services generally carry no copay and a twenty percent coinsurance. Emergency room visits require a flat copay that is waived upon admission, while urgent care services are subject to a twenty percent coinsurance. Supplemental benefits include dental services up to a two thousand dollar annual limit and routine eyewear up to a two hundred and fifty dollar yearly limit with no copay or coinsurance. Members also benefit from unlimited hearing aid fitting evaluations and over-the-counter hearing aids with no copay or coinsurance, plus up to thirty-six free one-way transportation trips per year to approved locations. Skilled nursing facility stays feature no copay for the first twenty days, followed by a daily copay with no coinsurance for days twenty-one through one hundred.
Inpatient Hospital See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and no coinsurance, and inpatient psychiatric stays with a $2,080 copay per stay and no coinsurance. While unlimited additional acute days are covered at no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers outpatient hospital services with a $525 copay and 20% coinsurance, and ambulatory surgical center services with a $375 copay and 20% coinsurance. Outpatient substance abuse and outpatient blood services are also covered with no copay and 20% coinsurance, with prior authorization required for these services.
Partial Hospitalization See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services are partially covered with no copay or coinsurance for up to 36 annual one-way trips to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers emergency services 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 per visit) and no copay, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers primary care, specialist, therapy, mental health, psychiatric, and telehealth services with no copay and 20% coinsurance, though prior authorization is generally required. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and select screenings. Additional preventive benefits are partially covered with no copay and no coinsurance for memory fitness, smoking cessation, in-home support, and chemotherapy-related wigs (up to $500 annually), while services like health education, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are covered by HumanaChoice SNP-DE H7617-084 (PPO D-SNP) with no deductible, featuring unlimited fitting evaluations and OTC hearing aids at no copay and no coinsurance. Routine hearing exams require a 20% coinsurance and no copay, while 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 types are not covered.
Vision Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) partially covers vision services, offering routine eye exams with no copay, 20% coinsurance, and no deductible up to a $75 annual limit. Covered eyewear includes contact lenses and eyeglasses with no copay, no coinsurance, and no deductible up to a $250 yearly limit, while other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) partially covers dental services up to a $2,000 annual maximum, offering no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require no copay and a 20% coinsurance. Fluoride treatments, implant services, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers home infusion bundled services, subject to prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, other Part B drugs have no copay and 0% to 20% coinsurance, and chemotherapy drugs require a copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HumanaChoice SNP-DE H7617-084 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with a 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers diagnostic and radiological services with a 20% coinsurance and prior authorization requirements. Lab services have no copay, outpatient X-rays require a $50 copay, diagnostic radiological services have a minimum $200 copay, and other diagnostic and therapeutic services also require copayments.
Home Health Services See details
Home Health Services are covered under the HumanaChoice SNP-DE H7617-084 (PPO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers some Cardiac Rehabilitation Services with no copay, though prior authorization is required. However, cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
HumanaChoice SNP-DE H7617-084 (PPO D-SNP) offers partial coverage for other services, which includes acupuncture with no copay and 20% coinsurance (up to 20 treatments yearly), as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Highly integrated services for dual eligible SNPs and other additional services (Other 1, 2, and 3) are not covered under this benefit.
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