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HumanaChoice Giveback H7617-094 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Giveback H7617-094 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Giveback H7617-094 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice Giveback H7617-094 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select counties in Georgia and South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Giveback H7617-094 (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 Giveback H7617-094 (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 Giveback H7617-094 (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 $130.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $500.00 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 Giveback H7617-094 (PPO) prescription drug plan features an annual drug deductible of $450. For Tier 1 preferred generic drugs, you will pay no copay for a one-month or three-month supply at standard pharmacies and preferred mail-order services. Tier 2 generic drugs are also highly affordable, starting at no copay for a three-month supply via preferred mail order or a $5 copay for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, which can be filled at standard pharmacies or mail-order services. For higher-tier medications, Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty drugs require a 27% coinsurance for a one-month supply.
Additional Benefits
The HumanaChoice Giveback H7617-094 (PPO) plan offers comprehensive medical coverage with predictable costs, featuring no copay and no coinsurance for primary care doctor visits and home health services. If you need specialist care or urgent care, you will pay a $40 copay with no coinsurance. Inpatient hospital stays require a $360 daily copay for the first seven days, after which there is no copay, while emergency room visits carry a $115 copay that is waived if you are admitted. For routine wellness, this plan provides preventive care, routine eye exams, routine eyewear, and many dental services with no copay and no coinsurance. Prescription hearing aids are covered with a copay ranging from $699 to $999, while diagnostic services like lab tests and X-rays have no copay. Most medical equipment and Medicare Part B drugs require no copay, instead carrying coinsurance ranging from 10% to 20%.
Inpatient Hospital See details
HumanaChoice Giveback H7617-094 (PPO) covers inpatient acute hospital stays with no coinsurance and a $360 daily copay for days 1 to 7, and no copay for days 8 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $360 daily copay for days 1 to 5, though upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HumanaChoice Giveback H7617-094 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services have no coinsurance with a copay ranging from $0 to $450 (or a $360 copay per stay for observation services), while outpatient substance abuse individual and group sessions carry no coinsurance and a $35 copay.
Partial Hospitalization See details
HumanaChoice Giveback H7617-094 (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 Giveback H7617-094 (PPO) covers ground and air ambulance services with a $335.00 copay and no coinsurance, subject to prior authorization, while transportation services are not covered.
Emergency Services See details
HumanaChoice Giveback H7617-094 (PPO) covers emergency services with a $115 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available for a $115 copay and no coinsurance.
Primary Care See details
HumanaChoice Giveback H7617-094 (PPO) primary care benefits feature no copay and no coinsurance for primary care physician visits, while specialist visits require a $40 copay and no coinsurance. Other covered services, including physical therapy ($25 copay), mental health sessions ($35 copay), and telehealth ($0 to $40 copay), also feature no coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by HumanaChoice Giveback H7617-094 (PPO) with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and post-welcome visit EKGs. However, many additional preventive services are not covered, including 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 benefits, palliative care, in-home support, caregiver support, smoking cessation, fitness benefits, disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
HumanaChoice Giveback H7617-094 (PPO) hearing services are partially covered, offering one annual routine exam and unlimited fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Up to two prescription hearing aids are covered annually with a $699 to $999 copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
HumanaChoice Giveback H7617-094 (PPO) vision services are partially covered with no deductible, offering routine eye exams and eyewear with no copay and no coinsurance. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
Dental services are partially covered by HumanaChoice Giveback H7617-094 (PPO), featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
HumanaChoice Giveback H7617-094 (PPO) covers home infusion bundled services with no copay, subject to prior authorization and step therapy. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the HumanaChoice Giveback H7617-094 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
HumanaChoice Giveback H7617-094 (PPO) covers durable medical equipment (DME) with a 15% coinsurance and no copay, and prosthetics and medical supplies with a 20% coinsurance and no copay. Diabetic supplies require a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HumanaChoice Giveback H7617-094 (PPO), offering lab services and outpatient X-rays with no copay. Outpatient diagnostic procedures and tests have no coinsurance and a copay between $0 and $120, while therapeutic radiological services require a minimum $40 copay and a minimum 20% coinsurance.
Home Health Services See details
HumanaChoice Giveback H7617-094 (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HumanaChoice Giveback H7617-094 (PPO) with no coinsurance, but prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HumanaChoice Giveback H7617-094 (PPO) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a three-day inpatient hospital stay is not required prior to admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HumanaChoice Giveback H7617-094 (PPO) partially covers other services, which include acupuncture for a $40 copay and no coinsurance (up to 20 treatments per year) and a meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered.
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