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HumanaChoice H7617-093 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-093 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-093 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-093 (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 H7617-093 (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 H7617-093 (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 H7617-093 (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 $1.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $400.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $450.00 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 H7617-093 (PPO) prescription drug plan has an annual drug deductible of $450. For Tier 1 preferred generics and Tier 2 generics, there is no copay for one-month and three-month supplies filled at standard pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs have a $10 copay and Tier 2 drugs have a $20 copay for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply at standard pharmacies and mail-order services, though a three-month preferred mail order reduces the cost to $131. Tier 4 non-preferred drugs require a 48% coinsurance across all pharmacy and mail-order options for both one-month and three-month supplies. Finally, Tier 5 specialty drugs incur a 27% coinsurance for a one-month supply.
Additional Benefits
The HumanaChoice H7617-093 (PPO) plan offers robust medical coverage, including primary care physician visits with no copay and specialist visits for a $40 copay. Inpatient hospital stays require a $375 daily copay for the first 5 to 7 days followed by no copay, while emergency care has a $115 copay that is waived if admitted. Outpatient services are covered with no coinsurance, featuring copays ranging from no copay up to $450 depending on the procedure. For supplemental wellness, this plan features no copay for preventive services, routine vision exams, and routine hearing exams. Dental services are covered up to a $2,500 annual limit, featuring no copay and coinsurance between 0% and 40% for most covered procedures. Additionally, home health services are available with no copay, and skilled nursing facility stays require no copay for the first 20 days.
Inpatient Hospital See details
HumanaChoice H7617-093 (PPO) inpatient hospital benefits are partially covered with no coinsurance, featuring a $375 daily copay for days 1 to 7 of acute stays and days 1 to 5 of psychiatric stays, followed by no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HumanaChoice H7617-093 (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $450 copay and outpatient observation services with a $375 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
HumanaChoice H7617-093 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
HumanaChoice H7617-093 (PPO) covers ground and air ambulance services with a $335 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HumanaChoice H7617-093 (PPO) emergency services are covered 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
Primary care benefits under HumanaChoice H7617-093 (PPO) are partially covered, offering primary care physician visits with no copay and no coinsurance, and specialist visits for a $40 copay and no coinsurance. Therapy and mental health services require copays between $25 and $35 with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
HumanaChoice H7617-093 (PPO) covers preventive services, such as annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are only partially covered, with fitness and in-home support services included, while other services like health education, personal emergency response systems, nutritional therapy, and home safety assessments are not covered.
Hearing Services See details
HumanaChoice H7617-093 (PPO) hearing services include Medicare-covered exams for a $40 copay and no coinsurance, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay of $199 to $499 for up to two aids per year, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
HumanaChoice H7617-093 (PPO) provides partially covered vision services with no deductibles and no coinsurance, featuring no copay for a yearly routine eye exam and one annual selection of contact lenses or eyeglasses. Other eye exam services, standalone eyeglass lenses, standalone frames, and upgrades are not covered under this plan.
Dental Services See details
HumanaChoice H7617-093 (PPO) dental services are partially covered up to a $2,500 annual maximum, with Medicare-covered services requiring a $40 copay and no coinsurance, while other covered services have no copay and 0% to 40% coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under HumanaChoice H7617-093 (PPO) with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy and other drugs have no copay and range from no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and ranges from no coinsurance up to 20% coinsurance.
Dialysis Services See details
HumanaChoice H7617-093 (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HumanaChoice H7617-093 (PPO) covers durable medical equipment and prosthetics with a 20% coinsurance and no copay, subject to prior authorization. Covered diabetic supplies require a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts carry a $10 copay.
Diagnostic and Radiological Services See details
HumanaChoice H7617-093 (PPO) covers diagnostic services with no coinsurance, offering lab services at no copay and diagnostic procedures with a copay ranging from $0 to $120. Covered radiological services include outpatient X-rays and diagnostic radiology starting at no copay, while therapeutic radiology requires a minimum 20% coinsurance and a minimum $40 copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice H7617-093 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice H7617-093 (PPO) with no coinsurance, but prior authorization is required. Some services are covered, but standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($25 copay), and SET for PAD services ($20 copay) are not covered in practice.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-093 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, and although a prior three-day hospital stay is not necessary, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by HumanaChoice H7617-093 (PPO), including acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, and a chronic illness meal benefit with no copay and no coinsurance. Prior authorization is required for these covered benefits, and over-the-counter (OTC) items are not covered.
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