Humana USAA Honor Giveback (HMO)

HUMANA WI HEALTH ORGANIZATION INSURANCE CORP · 2027 plan year

Plan ID H6622-094-000

HMO★ 4 CMS Stars
MOOP (in-network)
$6,750
MOOP (combined)
—
Monthly premium
$0/mo
Prescription drugs
Not included

This plan in 2026

Plan information

Contract / Plan / Segment
H6622-094-000
Medical deductible
$0 — no deductible
Also owed
Your Medicare Part B premium, paid separately

More HUMANA WI HEALTH ORGANIZATION INSURANCE CORP plans in MD

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$325/day for days 1–6, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$1,260 per stay
Worldwide Urgent Care Coverage$50

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Substance Abuse — Group SessionsNo charge
Medicare-Covered Preventive ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Skilled Nursing Facility (SNF)$10/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$30
Intensive Cardiac Rehabilitation — Additional Sessions$30
Pulmonary Rehabilitation — Additional Sessions$30
Supervised Exercise Therapy (SET)$25
Emergency Services$130
Urgently Needed Services$50
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Psychiatric Services — Group SessionsNo charge
Worldwide Emergency Transportation$325
Partial Hospitalization ProgramNo charge
Intensive Outpatient Program (IOP)No charge
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$35
Physician Specialist Services$40
Podiatry Services$40
Other Health Care Professional Services$0-$40
Psychiatric ServicesSee plan details
Physical Therapy & Speech-Language Pathology$35
Additional Telehealth Services (Part B)$0-$50
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$175
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$0-$780
Therapeutic Radiology$40 copay + 20% coinsurance
X-Ray Services$0-$145
Outpatient Hospital Services$0-$1,000
Hospital Observation Services$325 per stay
Ambulatory Surgical Center (ASC)$0-$900
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$325
Air Ambulance20% coinsurance
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies10%-20% coinsurance
Diabetic Therapeutic Shoes & Inserts$10
Diabetic Monitors10%-20% coinsurance
Dialysis Services20% coinsurance
Acupuncture$40
Meal BenefitNo charge
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$40
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Periodontics (Gum Care)No charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$40
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Hearing — Exams$40
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$499-$725

Service area

  • MD: 4 counties

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