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HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) in 2026, please refer to our full plan details page.
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) is a PPO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Southeast Florida. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP).
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 Florida SNP-DE H7617-113 (PPO D-SNP), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $615.00 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 $8950.00 (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 $8950.00 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 Florida SNP-DE H7617-113 (PPO D-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, there is no copay for one-month or three-month supplies filled at standard retail pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, you will pay a copay ranging from $10 to $20 for a one-month supply and $30 to $60 for a three-month supply. For Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order. This 25% coinsurance applies to both one-month and three-month supplies for Tiers 3 and 4, and one-month supplies for Tier 5 specialty medications.
Additional Benefits
The HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) offers comprehensive medical coverage, featuring no copay and no coinsurance for primary care, specialist visits, and preventive services. For emergency care, there is a $130 copay for emergency room visits and a $40 copay for urgent care, both with no coinsurance. Inpatient hospital stays require a $1,000 copay per admission with no coinsurance, though unlimited acute care days are provided with no copay. This plan also includes key supplemental benefits, offering routine dental, vision, and hearing care with no copay and no coinsurance up to specified plan limits. Covered dental services have an annual maximum of $1,250, while prescription hearing aids are covered up to $3,600 every three years and vision hardware has a $550 annual limit. Additionally, members can access home health services, acupuncture, and over-the-counter items with no copay and no coinsurance.
Inpatient Hospital See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,000 copay per admission and no coinsurance, subject to prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute care days are provided with no copay.
Outpatient Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers outpatient hospital services with a $0 to $35 copay and 20% coinsurance, and ambulatory surgical center services with no copay and 20% coinsurance. Outpatient substance abuse services feature a $0 to $35 copay and no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers partial hospitalization services with a $35 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services to plan-approved locations are covered with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers emergency services with a $130 copay and no coinsurance, which 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 with a $130 copay and no coinsurance.
Primary Care See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers primary care, specialist, mental health, psychiatric, and podiatry services with no copay and no coinsurance, though chiropractic services are not covered. Physical and occupational therapy require no copay and a 20% coinsurance, while telehealth and opioid treatments feature no coinsurance and copays ranging up to $40 and $35, respectively.
Preventive Services See details
Preventive services are partially covered by HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, in-home support, and select screenings. While memory fitness, smoking cessation counseling, and chemotherapy wigs (up to $500 annually) are covered with no copay and no coinsurance, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers routine hearing exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $3,600 limit every three years, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Vision services are partially covered by HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) with no copay, no coinsurance, and no deductible, though prior authorization is required. Covered benefits include one routine eye exam (up to $40) and one pair of contact lenses or eyeglasses (lenses and frames) per year with a combined $550 maximum benefit, while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) offers partially covered dental services with no copay and no coinsurance up to a combined annual maximum of $1,250 for in-network and out-of-network care. Covered services include oral exams, cleanings, x-rays, and restorative care, while fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers home infusion bundled services with prior authorization, offering Medicare Part B insulin for a $35 copay and 0% to 20% coinsurance. Other covered Medicare Part B drugs, including chemotherapy and radiation drugs, require a 0% to 20% coinsurance, with no copay required for other Part B drugs.
Dialysis Services See details
Dialysis Services are covered under HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment benefits under the HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) plan are covered with no copays across all categories, though prior authorization is required. Durable medical equipment, prosthetics, and medical supplies carry a 20% coinsurance, while diabetic equipment and supplies are available with no coinsurance.
Diagnostic and Radiological Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers diagnostic and radiological services with a 20% coinsurance, subject to prior authorization. Outpatient diagnostic procedures and tests have a copay ranging from no copay to $40, while lab services, X-rays, and radiological services require no copay.
Home Health Services See details
Home Health Services are covered under the HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers cardiac rehabilitation services with prior authorization, requiring a 20% coinsurance and no copay. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $185 daily copay for days 21 through 100, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other services are partially covered by HumanaChoice Florida SNP-DE H7617-113 (PPO D-SNP) with no copay and no coinsurance for acupuncture, over-the-counter items, and meal benefits. Prior authorization is required for acupuncture (limited to 25 treatments per year) and meals, while sub-services listed as Other 1, Other 2, Other 3, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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