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HumanaChoice H7617-095 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice H7617-095 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice H7617-095 (PPO) in 2026, please refer to our full plan details page.
HumanaChoice H7617-095 (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 H7617-095 (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 H7617-095 (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 H7617-095 (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 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 $10100.00 (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 $10100.00 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 H7617-095 (PPO) Medicare prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, you will pay no copay for 1-month or 3-month supplies at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, costing as little as a $5 copay for a 1-month supply at standard pharmacies or no copay for a 3-month supply through preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply across most pharmacy and mail order options, with 3-month supplies starting at $131 through preferred mail order. Higher-tier medications require coinsurance instead of flat copays, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 29% coinsurance for a 1-month supply.
Additional Benefits
The HumanaChoice H7617-095 (PPO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, while specialist visits require a $15 copay. For hospital stays, inpatient care requires a $345 daily copay for the first eight days of acute stays with no coinsurance, and emergency care carries a $130 copay. Outpatient hospital services feature copays ranging from no copay up to $450 with no coinsurance. This plan also includes valuable supplemental benefits, such as preventive services and routine eye exams with no copay. Dental care is covered with no copay for preventive services and a $2,500 annual maximum benefit, while routine hearing exams have no copay and prescription hearing aids require copays between $199 and $499. Additionally, home health services require no copay, while dialysis and durable medical equipment are covered with a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by HumanaChoice H7617-095 (PPO) with no coinsurance, requiring a $345 daily copay for days 1-8 of acute stays (no copay thereafter) and days 1-6 of psychiatric stays (no copay for days 7-90). Prior authorization is required, and certain sub-services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by HumanaChoice H7617-095 (PPO) with no coinsurance, although prior authorization is required. Outpatient blood and ambulatory surgical center services have no copay, while outpatient substance abuse sessions require a $35 copay, observation services cost a $345 copay per stay, and outpatient hospital services carry a copay ranging from $0 to $450.
Partial Hospitalization See details
HumanaChoice H7617-095 (PPO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
HumanaChoice H7617-095 (PPO) covers Medicare-approved ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services under HumanaChoice H7617-095 (PPO) are covered with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice H7617-095 (PPO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $15 copay and no coinsurance. Other covered benefits like occupational therapy ($25 copay) and mental health services ($35 copay) also feature 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 H7617-095 (PPO) with no copay and no coinsurance for covered services, which include annual physical exams, kidney disease education, in-home support, and fitness benefits. However, several additional services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
HumanaChoice H7617-095 (PPO) covers hearing exams with no coinsurance, requiring a $15 copay for Medicare-covered exams and no copay for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $199 to $499, though OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HumanaChoice H7617-095 (PPO) partially covers vision services with no deductible, no coinsurance, and copays ranging from no copay to $15. While routine eye exams, contact lenses, and complete eyeglasses are covered, other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice H7617-095 (PPO) provides partially covered dental services with an annual maximum benefit of $2,500 for both in-network and out-of-network care. Medicare-covered dental services require a $15 copay and no coinsurance, while other covered preventive and comprehensive services feature no copay and no coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
HumanaChoice H7617-095 (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, feature no coinsurance to 20% coinsurance, with insulin drugs requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered under the HumanaChoice H7617-095 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Medical Equipment See details
HumanaChoice H7617-095 (PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay, with prior authorization required for most items.
Diagnostic and Radiological Services See details
HumanaChoice H7617-095 (PPO) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a copay of up to $120. Covered radiological services include outpatient X-rays and diagnostic radiology with no copays, while therapeutic radiology requires a minimum 20% coinsurance and a minimum $15 copay.
Home Health Services See details
Home Health Services are covered by HumanaChoice H7617-095 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the HumanaChoice H7617-095 (PPO) plan with no coinsurance and a prior authorization requirement, though only some services are covered in practice. Specifically, cardiac rehabilitation (with a $40 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $35 copay), and SET for PAD services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice H7617-095 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily 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 Medicare-covered 100 days are not covered.
Other Services See details
HumanaChoice H7617-095 (PPO) partially covers other services, offering acupuncture with a $15.00 copay and no coinsurance for up to 20 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items, dual-eligible SNP services, and other additional services are not covered.
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