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HumanaChoice H7617-092 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-092 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-092 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-092 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Georgia. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice H7617-092 (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 H7617-092 (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 H7617-092 (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.
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 $350.00 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:
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Drug Coverage
The HumanaChoice H7617-092 (PPO) Medicare prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, members pay no copay at standard pharmacies and through preferred mail order for both 1-month and 3-month supplies. Tier 2 generic drugs cost a $5 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay for a 3-month supply through preferred mail order. Tier 3 preferred brand drugs generally require a $47 copay for a 1-month supply, though a 3-month supply through preferred mail order is reduced to a $131 copay. For higher-tier medications, members pay coinsurance, which is 47% for Tier 4 non-preferred drugs and 29% for Tier 5 specialty drugs. These details help you understand your out-of-pocket costs when choosing the HumanaChoice H7617-092 (PPO) plan.
Additional Benefits
The HumanaChoice H7617-092 (PPO) plan offers affordable medical coverage with no copay or coinsurance for primary care visits and preventive services. Specialist visits require a $20 copay, while emergency room visits carry a $115 copay that is waived upon hospital admission. For inpatient hospital stays, patients pay a $375 daily copay for the first seven days, with no copay and no coinsurance for subsequent days. Routine dental, vision, and hearing care are well-supported, featuring no copay for annual eye and hearing exams, plus routine dental services up to a $1,500 annual limit. Home health care is provided with no copay, and skilled nursing facility stays have no copay for the first 20 days. Lastly, medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by HumanaChoice H7617-092 (PPO) with no coinsurance, requiring a daily copay of $375 for days 1 through 7 of acute stays (no copay for days 8 and beyond) and days 1 through 5 of psychiatric stays (no copay for days 6 through 90). Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-092 (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $450 copay and observation services with a $375 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay or coinsurance, while outpatient substance abuse sessions carry a $35 copay. Prior authorization is required for these outpatient services.
Partial Hospitalization See details
HumanaChoice H7617-092 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
HumanaChoice H7617-092 (PPO) covers ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
HumanaChoice H7617-092 (PPO) 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 require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-092 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $20 copay and no coinsurance. Additional services like therapy, mental health, and telehealth feature copays ranging from $0 to $35 with no coinsurance, though podiatry is not covered and chiropractic services are only partially covered with routine care excluded.
Preventive Services See details
Preventive services are partially covered by HumanaChoice H7617-092 (PPO) with no copay and no coinsurance for covered care such as annual physicals, kidney disease education, glaucoma screenings, diabetes training, EKGs, fitness benefits, and in-home support. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access, home and bathroom safety modifications, and counseling.
Hearing Services See details
HumanaChoice H7617-092 (PPO) covers Medicare-covered hearing exams for a $20 copay and no coinsurance, while routine exams and fitting evaluations are offered with no copay and no coinsurance. Prescription hearing aids are partially covered with a copay ranging from $699 to $999 and no coinsurance for up to two devices per year, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
HumanaChoice H7617-092 (PPO) offers partially covered vision services with no deductibles, featuring no copay and no coinsurance for annual routine eye exams (up to $75) and covered eyewear (up to $150). One routine exam and one pair of contact lenses or eyeglasses (lenses and frames) are covered per year, while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by HumanaChoice H7617-092 (PPO), which features a $1,500 combined annual limit for in-network and out-of-network care. Medicare-covered dental services require a $20 copay and no coinsurance, while other covered dental services have no copay and no coinsurance; however, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice H7617-092 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by the HumanaChoice H7617-092 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
HumanaChoice H7617-092 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay and a 10% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-092 (PPO) covers diagnostic and radiological services with no coinsurance for diagnostic services, no copay for lab and outpatient X-ray services, and diagnostic test copays ranging from $0 to $120. Diagnostic radiological services have copays starting at $0, while therapeutic radiological services require a minimum 20% coinsurance and a $20 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-092 (PPO) plan with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice H7617-092 (PPO) with no coinsurance, though prior authorization is required. Some services are covered, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copays ranging from $20.00 to $30.00.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-092 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice H7617-092 (PPO) provides partial coverage for other services, including acupuncture and chronic illness meals, while over-the-counter (OTC) items are not covered. Acupuncture is covered with a $20.00 copay and no coinsurance for up to 20 treatments per year, and the meal benefit is covered with no copay and no coinsurance, with both services requiring prior authorization.
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