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Humana Inc.

Plan ID: H5216-256-0

Humana USAA Honor Giveback (PPO)

2025 Humana USAA Honor Giveback (PPO) H5216 — 256 — 0 is a Medicare Advantage plan . It has received a 3.5-out-of-5 star rating from CMS for 2025.

Learn more about Humana USAA Honor Giveback (PPO) H5216 - 256 - 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.

3.5 / 5 stars for 2025

$0.00 /mo

Monthly premium

$4900.00

Out-of-pocket maximum

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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

2025 Humana USAA Honor Giveback (PPO) H5216 — 256 — 0 is a PPO offered in Treasure Coast by Humana Inc.. It has a monthly premium of $0.00.

Premium Breakdown

Standard Part B Premium

$185.00

Part B premium reduction

- $0

Monthly Plan Premium

$0.00

Total Premium:

$185.00

Note:

The standard Medicare Part B premium for 2025 is $185.00. Your premium may differ based on factors like late enrollment, income (IRMAA), or disability status. Most people enrolled in Medicare Part B are required to pay this premium.

Special needs plan type

Out-of-pocket maximum

$4900.00

Plan Organization:

Humana Inc.

Plan Type:

PPO

Location:

Treasure Coast

Drugs Covered:

Drug Formulary:

Formulary Link

Pharmacies:

Pharmacies Link

Doctor Choice:

Doctors Link:

Doctors Link

Deductibles

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

Sign up for Humana USAA Honor Giveback (PPO)

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 USAA Honor Giveback (PPO) does not provide drug coverage. If drug coverage is something you need, you should consider shopping for other plans that do provide cost sharing on drugs.

Additional Benefits

Humana USAA Honor Giveback (PPO) also provides the following benefits.

Note:

Limits, Authorizations, and Referrals may apply for the benefits below. Contact the plan for details.

Comprehensive dental

Adjunctive General Services

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Endodontics

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Oral and Maxillofacial Surgery

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Periodontics

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Prosthodontics, fixed

In-Network: 30 Coins - 0.00 Copay

Prosthodontics, removable

In-Network: 30 Coins - 0.00 Copay

Restorative Services

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Preventive dental

Dental X-Rays

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Oral Exams

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Other Diagnostic Dental Services

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Other Preventive Dental Services

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Prophylaxis (cleaning)

In-Network: No Coins - 0.00 Copay

Out-Of-Network: No Coins - 0.00 Copay

Diagnostic procedures/lab services/imaging

Diagnostic radiology services

Lab services

In-Network: $0-15 copay or 20% coinsurance

Out-Of-Network: $65 copay or 50% coinsurance

Diagnostic tests and procedures

In-Network: $0-200 copay or 20% coinsurance

Out-Of-Network: $65 copay or 50% coinsurance

Outpatient x-rays

In-Network: $0-40 copay or 20% coinsurance

Out-Of-Network: $65 copay or 50% coinsurance

Doctor visits

Primary

In-Network: $0 copay

Out-Of-Network: $65 copay per visit

Specialist

In-Network: $40 copay per visit

Out-Of-Network: $65 copay per visit

Emergency care/Urgent care

Urgent care

$15 copay per visit (always covered)

Emergency

$125 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment

In-Network: $40 copay

Out-Of-Network: $65 copay

Routine foot care

Not covered

Ground ambulance

All service types

In-Network: $120-240 copay

Out-Of-Network: $120-240 copay

Hearing

Fitting/evaluation

In-Network: $0 copay

Out-Of-Network: 50% coinsurance

Hearing aids

In-Network: $0 copay

Out-Of-Network: $0 copay

Hearing aids OTC

In-Network: $0 copay

Out-Of-Network: $0 copay

Medicare-Covered Hearing Exam

In-Network: $40 copay

Out-Of-Network: $65 copay

Inpatient hospital coverage

All service types

In-Network: $225 per day for days 1 through 8 $0 per day for days 9 through 90 $0 per day for days 91 and beyond

Out-Of-Network: $225 per day for days 1 through 8 $0 per day for days 9 through 90

Outpatient hospital coverage

All service types

In-Network: $0-225 copay or 20% coinsurance per visit

Out-Of-Network: $65 copay or 50% coinsurance per visit

Optional benefits

All service types

Medical equipment/supplies

Diabetes supplies

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

Out-Of-Network: 50% coinsurance per item

Durable medical equipment

Prosthetics

Medicare Part B drugs

Other Part B drugs

In-Network: 0-19% coinsurance

Out-Of-Network: 19% coinsurance

Chemotherapy

In-Network: 0-19% coinsurance

Out-Of-Network: 50% coinsurance

Mental health services

Inpatient hospital - psychiatric

In-Network: $225 per day for days 1 through 8 $0 per day for days 9 through 90

Out-Of-Network: $225 per day for days 1 through 8 $0 per day for days 9 through 90

Outpatient group therapy visit

In-Network: $30 copay

Out-Of-Network: $65 copay

Outpatient group therapy visit with a psychiatrist

In-Network: $30 copay

Out-Of-Network: $65 copay

Outpatient individual therapy visit

In-Network: $30 copay

Out-Of-Network: $65 copay

Outpatient individual therapy visit with a psychiatrist

In-Network: $30 copay

Out-Of-Network: $65 copay

Preventive care

All service types

In-Network: $0 copay

Out-Of-Network: $0 copay or 50% coinsurance

Rehabilitation services

Occupational therapy visit

In-Network: $10-40 copay

Out-Of-Network: $65 copay or 50% coinsurance

Physical therapy and speech and language therapy visit

In-Network: $10-40 copay

Out-Of-Network: $65 copay or 50% coinsurance

Skilled Nursing Facility

All service types

In-Network: $0 per day for days 1 through 20 $160 per day for days 21 through 100

Out-Of-Network: $250 per day for days 1 through 58 $0 per day for days 59 through 100

Transportation

All service types

Not covered

Vision

Eyeglass lenses

Not covered

Routine eye exam

In-Network: $0 copay

Out-Of-Network: $0 copay

Contact lenses

In-Network: $0 copay

Out-Of-Network: $0 copay

Upgrades

Not covered

Eyeglasses (frames and lenses)

In-Network: $0 copay

Out-Of-Network: $0 copay

Eyeglass frames

Not covered

Other

Not covered

Wellness programs (eg, fitness, nursing hotline)

All service types

Covered

Plan Providers

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, Capital Blue Cross, 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.

Get Personalized Help from a licensed insurance agent

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

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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.

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