Get help from a licensed insurance agent 1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week.

A trusted, non-government entity.

Enroll

Humana

Plan ID: H5216-401-0

Humana Together in Health (PPO I-SNP)

2024 Humana Together in Health (PPO I-SNP) H5216 — 401— 0 is a Medicare Advantage plan with drug coverage. It has received a 4.5-out-of-5 star rating from CMS for 2024.

Learn more about Humana Together in Health (PPO I-SNP) H5216 - 401 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.

4.5 / 5 stars for 2024

$18.40 /mo

Monthly premium

Coming soon

Health deductible

$545.00

Drug deductible

Out-of-pocket maximum

Enroll online

Call to enroll

Get personalized help from a licensed insurance agent
1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week!

Overview Benefits & Costs Drug Coverage Additional Benefits

Plan Overview

2024 Humana Together in Health (PPO I-SNP) H5216 — 401— 0 is a Local PPO offered in Ohio by Humana. It has a monthly premium of $18.40.

Important:

2024 Humana Together in Health (PPO I-SNP) H5216 — 401 — 0 is a Institutional Special Needs Type plan. You can only enroll in this plan if you meet specific criteria.

Premium Breakdown

Standard Part B Premium

$174.80

Part B premium reduction

Part C Premium

Part D Basic Premium

$18.40

Part D Supplemental Premium

Part D Total

$18.40

Monthly Premium (Parts C & D)

$18.40

Total Premium (Parts B, C, & D)

$183.30

Special needs plan type

Yes

Out-of-pocket maximum

Conditions Covered

None

Plan Organization:

Humana

Plan Type:

Local PPO

Location:

Ohio

Drugs Covered:

Yes

Drug Formulary:

Formulary Link

Pharmacies:

Pharmacies Link

Doctor Choice:

Any Doctor

Doctors Link:

Doctors Link

Deductibles

The amount you must pay each year before your plan starts to pay for covered services or drugs.

Health deductible

Coming soon

Drug deductible

$545

Note:

This plan does not charge an annual deductible for all drugs. The $545.00 annual deductible only applies to drugs in certain tiers.

Sign up for Humana Together in Health (PPO I-SNP)

Enroll online

Call to enroll

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

Humana Together in Health (PPO I-SNP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Benefit Type

Defined Standard Benefit

Prescription drug deductible

$545.00

Increased initial coverage limit

Additional gap coverage

Part D Premium Reduction

This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.

Part D	LIS 25%	LIS 50%	LIS 75%	LIS Full
$18.40	$18.40	$18.40	$18.40	$18.40

Initial Coverage Phase

After you pay your $545.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.

30 Days

60 Days

90 Days

Tier	Preferred Pharmacy	Standard Pharmacy	Preferred Mail	Standard Mail
1. Preferred Generic	-	25%	-	25%
2. Standard Generic	-	-	-	-
3. Preferred Brand	-	-	-	-
4. Non-Preferred Drug	-	-	-	-
5. Specialty Tier	-	-	-	-

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

Generic Drugs

$4.15 copay or 5% (whichever costs more)

Brand-name

$10.35 copay or 5% (whichever costs more)

Additional Benefits

Humana Together in Health (PPO I-SNP) also provides the following benefits.

Comprehensive dental

Non-routine services

In-Network: $0 copay

Out-Of-Network: $0 copay

Diagnostic services

In-Network: $0 copay

Out-Of-Network: $0 copay

Restorative services

In-Network: $0 copay

Out-Of-Network: $0 copay

Endodontics

In-Network: $0 copay

Out-Of-Network: $0 copay

Periodontics

In-Network: $0 copay

Out-Of-Network: $0 copay

Extractions

In-Network: $0 copay

Out-Of-Network: $0 copay

Prosthodontics, other oral/maxillofacial surgery, other services

In-Network: $0 copay

Out-Of-Network: $0 copay

Preventive dental

Oral exam

In-Network: $0 copay

Out-Of-Network: $0 copay

Cleaning

In-Network: $0 copay

Out-Of-Network: $0 copay

Fluoride treatment

In-Network: $0 copay

Out-Of-Network: $0 copay

Dental x-ray(s)

In-Network: $0 copay

Out-Of-Network: $0 copay

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures

In-Network: $0-35 copay or 20% coinsurance

Out-Of-Network: $0-35 copay or 20% coinsurance

Lab services

In-Network: $0 copay or 20% coinsurance

Out-Of-Network: $0 copay or 20% coinsurance

Diagnostic radiology services (eg, MRI)

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Outpatient x-rays

In-Network: $0-35 copay or 20% coinsurance

Out-Of-Network: $0-35 copay or 20% coinsurance

Doctor visits

Primary

In-Network: $0 copay

Out-Of-Network: $0 copay

Specialist

In-Network: 20% coinsurance per visit

Out-Of-Network: 20% coinsurance per visit

Emergency care/Urgent care

Emergency

$100 copay per visit (always covered)

Urgent care

20% coinsurance per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Routine foot care

In-Network: $10 copay

Ground ambulance

Service

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Hearing

Hearing exam

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Fitting/evaluation

In-Network: $0 copay

Out-Of-Network: 50% coinsurance

Hearing aids

In-Network: $0-299 copay

Out-Of-Network: 50% coinsurance

Inpatient hospital coverage

Service

In-Network: $569 per day for days 1 through 4 $0 per day for days 5 through 90 $0 per day for days 90 and beyond

Out-Of-Network: $569 per day for days 1 through 4 $0 per day for days 5 through 90

Outpatient hospital coverage

Service

In-Network: $35 copay or 20% coinsurance per visit

Out-Of-Network: $35 copay or 20% coinsurance per visit

Outpatient prescription drugs

Humana Together in Health (PPO I-SNP) does not provide this type of benefit.

Optional benefits

Humana Together in Health (PPO I-SNP) does not provide this type of benefit.

Medical equipment/supplies

Durable medical equipment (eg, wheelchairs, oxygen)

In-Network: 20% coinsurance per item

Out-Of-Network: 20% coinsurance per item

Prosthetics (eg, braces, artificial limbs)

In-Network: 20% coinsurance per item

Out-Of-Network: 20% coinsurance per item

Diabetes supplies

In-Network: $0 copay

Out-Of-Network: $0 copay

Medicare Part B drugs

Chemotherapy

In-Network: 0-20% coinsurance

Out-Of-Network: $0 copay or 20% coinsurance

Other Part B drugs

In-Network: $0 copay or 0-20% coinsurance

Out-Of-Network: $0 copay or 20% coinsurance

Part B Insulin drugs

In-Network: $0 copay or 0-20% coinsurance

Out-Of-Network: $0 copay or 20% coinsurance

Mental health services

Inpatient hospital - psychiatric

In-Network: $484 per day for days 1 through 4 $0 per day for days 5 through 90

Out-Of-Network: $484 per day for days 1 through 4 $0 per day for days 5 through 90

Outpatient group therapy visit with a psychiatrist

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Outpatient individual therapy visit with a psychiatrist

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Outpatient group therapy visit

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Outpatient individual therapy visit

In-Network: 20% coinsurance

Out-Of-Network: 20% coinsurance

Preventive care

Service

In-Network: $0 copay

Out-Of-Network: $0 copay

Rehabilitation services

Occupational therapy visit

In-Network: $0 copay

Out-Of-Network: $0 copay

Physical therapy and speech and language therapy visit

In-Network: $0 copay

Out-Of-Network: $0 copay

Skilled Nursing Facility

Service

In-Network: $0 per day for days 1 through 100

Out-Of-Network: $0 per day for days 1 through 100

Transportation

Service

In-Network: $0 copay

Vision

Routine eye exam

In-Network: $0 copay

Out-Of-Network: $0 copay

Other

Not covered

Contact lenses

In-Network: $0 copay

Out-Of-Network: $0 copay

Eyeglasses (frames and lenses)

In-Network: $0 copay

Out-Of-Network: $0 copay

Eyeglass frames

Not covered

Eyeglass lenses

Not covered

Upgrades

Not covered

Wellness programs (eg, fitness, nursing hotline)

Service

Not covered

Get Personalized Help from a licensed insurance agent

1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week

Enroll Online

Call to Enroll

SMID: MULTIPLAN_HCIHNMEDADVRX24_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 give-back 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.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

All plan-related information on this site is publicly available information from CMS.gov, Medicare.gov, and NIH.Gov. Plans vary by region and state. We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature.

Enrollment is offered through our partners, including HealthCompare Insurance Services. HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 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.

HealthCompare Insurance Services represents 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.

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

Medicare has neither approved nor endorsed any information on this site.

About Contact Legal & Privacy Sitemap

Speak with a licensed insurance agent: 1-877-649-2073 TTY 711 | 8am - 11pm ET | 7 days a week