A non-government entity
Humana Value Choice H7617-098 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Value Choice H7617-098 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Value Choice H7617-098 (PPO) in 2026, please refer to our full plan details page.
Humana Value Choice H7617-098 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Virginia. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Value Choice H7617-098 (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 Humana Value Choice H7617-098 (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 Humana Value Choice H7617-098 (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:
Sign up for Humana Value Choice H7617-098 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Value Choice H7617-098 (PPO) Medicare prescription drug plan features an annual drug deductible of $350. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs when using standard pharmacies or preferred mail order services. For Tier 2 generic medications, copays are as low as $5 for a one-month supply, with no copay required for a three-month supply filled via preferred mail order. Tier 3 preferred brand-name drugs require a $47 copay for a one-month supply across standard pharmacies and mail-order options. Higher-tier medications incur coinsurance rather than set copays, with Tier 4 non-preferred drugs requiring a 47% coinsurance and Tier 5 specialty drugs requiring a 29% coinsurance. Choosing preferred mail order and standard pharmacies helps keep your out-of-pocket prescription costs manageable under this PPO plan.
Additional Benefits
The Humana Value Choice H7617-098 (PPO) plan offers affordable medical coverage with no copay or coinsurance for primary care visits, preventive screenings, and home health services. Specialist visits require a budget-friendly $15 copay, while emergency room visits carry a $115 copay that is waived if you are admitted to the hospital. For inpatient hospital stays, members pay a $345 daily copay for the first several days of acute or psychiatric care and no copay for the remaining days. Supplemental benefits are a highlight of this plan, featuring routine hearing and vision exams with no copay, alongside a generous $400 annual allowance for eyeglasses or contacts. Routine dental care is also highly accessible, offering no copay or coinsurance for covered services up to a $1,750 yearly limit. Additionally, diagnostic lab tests and outpatient X-rays require no copay, while durable medical equipment is covered with a standard 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Value Choice H7617-098 (PPO) covers inpatient hospital services with no coinsurance, requiring a $345 daily copay for days 1 through 8 of acute stays and days 1 through 6 of psychiatric stays, with no copay for remaining days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Value Choice H7617-098 (PPO) covers outpatient hospital services with no coinsurance and a copay ranging from $0 to $450, and observation services with a $345 copay per stay. Ambulatory surgical center and outpatient blood services feature no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Value Choice H7617-098 (PPO) with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Value Choice H7617-098 (PPO) covers Medicare-approved ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered, but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Humana Value Choice H7617-098 (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 $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Value Choice H7617-098 (PPO) primary care services feature no copay and no coinsurance for primary care physician visits, and a $15 copay with no coinsurance for specialist visits. Physical, occupational, and speech therapies require a $25 copay, mental health and psychiatric services require a $35 copay, and telehealth ranges from a $0 to $50 copay—all with no coinsurance—while podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive services under the Humana Value Choice H7617-098 (PPO) are partially covered, offering annual physical exams, kidney disease education, memory fitness, and select screenings with no copay and no coinsurance. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Humana Value Choice H7617-098 (PPO) covers Medicare-covered hearing exams with a $15 copay and no coinsurance, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with a $199 to $499 copay and no coinsurance, but inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Humana Value Choice H7617-098 (PPO) vision services are partially covered with no copay and no coinsurance, offering one routine eye exam and up to $400 yearly for eyeglasses or contact lenses. Other eye exams, standalone eyeglass lenses, standalone eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Value Choice H7617-098 (PPO) partially covers dental services with a $15 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered dental services up to a $1,750 annual limit. While preventive and comprehensive services like cleanings and restorative care are covered, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Value Choice H7617-098 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the Humana Value Choice H7617-098 (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Value Choice H7617-098 (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 or inserts require a $10 copay and coinsurance.
Diagnostic and Radiological Services See details
Humana Value Choice H7617-098 (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Members will pay no copay and no coinsurance for lab services and outpatient X-rays, a $0 to $120 copay with no coinsurance for diagnostic procedures, and a minimum $15 copay and 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by Humana Value Choice H7617-098 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Value Choice H7617-098 (PPO) with no copay and no coinsurance, although prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Value Choice H7617-098 (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 prior three-day inpatient hospital stay is not required, and additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
Humana Value Choice H7617-098 (PPO) provides partially covered other services, which include acupuncture with a $15.00 copay and no coinsurance, and meals for qualifying medical conditions with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit, and prior authorization is required for the covered services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved