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Humana Essentials Plus Giveback H7617-100 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Essentials Plus Giveback H7617-100 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Essentials Plus Giveback H7617-100 (PPO) in 2026, please refer to our full plan details page.
Humana Essentials Plus Giveback H7617-100 (PPO) is a PPO plan offered by Humana Inc. available for enrollment in 2026 to people living in Virginia and Delaware. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Essentials Plus Giveback H7617-100 (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 Essentials Plus Giveback H7617-100 (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 Essentials Plus Giveback H7617-100 (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 $117.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $350.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $360.00 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 Humana Essentials Plus Giveback H7617-100 (PPO) Medicare plan features an annual drug deductible of $360. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic medications are also highly affordable, costing as little as a $1 copay for a 1-month supply, or no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $30 copay for a 1-month supply at standard pharmacies and preferred mail order, while standard mail order costs $47. For higher-tier prescriptions, Tier 4 non-preferred drugs incur a 34% coinsurance across all pharmacy options, and Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The Humana Essentials Plus Giveback H7617-100 (PPO) plan offers comprehensive medical coverage with no copay for primary care visits, preventive care, and home health services. For more specialized care, members will pay a $35 copay for specialist visits, a $345 daily copay for the first few days of inpatient hospital stays, and a $115 copay for emergency room visits. Outpatient hospital services range from no copay to a $450 copay, while ambulance transports carry a $335 copay. For supplemental care, routine dental, vision, and hearing exams are covered with no copay, though prescription hearing aids require copays ranging from $699 to $999. Durable medical equipment and dialysis services require no copay but carry a 17% and 20% coinsurance, respectively. This plan helps keep out-of-pocket costs predictable by offering no deductibles for many routine, dental, and vision services.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Essentials Plus Giveback H7617-100 (PPO) with no coinsurance, featuring a $345 daily copay for days 1 to 7 of acute stays and days 1 to 5 of psychiatric stays, followed by no copay for remaining covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $450, observation services carry a $345 copay per stay, and outpatient substance abuse sessions have a $35 copay, with prior authorization required for most services.
Partial Hospitalization See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers partial hospitalization services with a $35 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by Humana Essentials Plus Giveback H7617-100 (PPO) with a $335 copay and no coinsurance for both ground and air transport, subject to prior authorization. Routine transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Humana Essentials Plus Giveback H7617-100 (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 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, psychiatric care, and mental health services require a $35 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $25 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered care, including annual physical exams, kidney disease education, and memory fitness. However, several supplemental services are not covered, such as health education, weight management programs, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) hearing services are partially covered with no deductibles, featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fitting evaluations. While prescription hearing aids are covered up to two per year with no coinsurance and copays ranging from $699 to $999, OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Humana Essentials Plus Giveback H7617-100 (PPO) with no deductible, no coinsurance, no copay for routine eye exams (up to $75 annually), and no copay for eyeglasses or contact lenses (up to $150 annually). 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 the Humana Essentials Plus Giveback H7617-100 (PPO) plan, featuring a $35 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care and other covered services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Humana Essentials Plus Giveback H7617-100 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers durable medical equipment (DME) with a 17% coinsurance and no copay, and 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, with prior authorization required for most services.
Diagnostic and Radiological Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers diagnostic and radiological services with prior authorization, including lab services and outpatient X-rays with no copay. Diagnostic tests feature no coinsurance and a copay of $0 to $120, while therapeutic radiological services require a minimum 20% coinsurance and a $35 copay.
Home Health Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers cardiac rehabilitation services with no copay and no coinsurance, although in practice only some services are covered because cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Essentials Plus Giveback H7617-100 (PPO) covers skilled nursing facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, no prior three-day inpatient hospital stay is needed, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other services under the Humana Essentials Plus Giveback H7617-100 (PPO) are partially covered, featuring acupuncture with a $35 copay and no coinsurance (up to 20 treatments per year) and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for these covered services, while over-the-counter (OTC) items are not covered.
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