Humana USAA Honor Giveback (PPO)

HUMANA INSURANCE COMPANY · 2027 plan year

Plan ID H5216-436-002

Local PPO★ 4 CMS Stars
MOOP (in-network)
$6,200
MOOP (combined)
$9,800
Monthly premium
$0/mo
Prescription drugs
Not included

This plan in 2026

Plan information

Contract / Plan / Segment
H5216-436-002
Medical deductible
$250
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

More HUMANA INSURANCE COMPANY plans in CO

Benefits & cost sharing

Hospital

BenefitIn-network
Worldwide Urgent Care Coverage$40
Inpatient Hospital — Acute$325/day for days 1–6, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$325/day for days 1–6, $0 after

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

Other

BenefitIn-network
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Worldwide Emergency Transportation$325
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$115
Partial Hospitalization Program$35
Intensive Outpatient Program (IOP)$35
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$40
Physician Specialist Services$45
Podiatry Services$45
Podiatry Services$45
Other Health Care Professional Services$0-$45
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language Pathology$40
Additional Telehealth Services (Part B)$0-$45
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-$345
Therapeutic Radiology$45 copay + 20% coinsurance
X-Ray Services$0-$145
Outpatient Hospital Services$0-$450
Hospital Observation Services$325 per stay
Ambulatory Surgical Center (ASC)$0-$375
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$325
Air Ambulance$1,800
Durable Medical Equipment (DME)17% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices17% coinsurance
Medical Supplies17% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies10%-20% coinsurance
Diabetic Therapeutic Shoes & Inserts$10
Diabetic Monitors10%-20% coinsurance
Dialysis Services20% coinsurance
Acupuncture$45
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
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$45
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services0%-30% coinsurance
Dental — Endodontics (Root Canal)0%-30% coinsurance
Dental — Periodontics (Gum Care)0%-30% coinsurance
Dental — Removable Prosthodontics (Dentures)30% coinsurance
Dental — Fixed Prosthodontics (Bridges)0%-30% coinsurance
Dental — Oral & Maxillofacial Surgery0%-30% coinsurance
Dental — Adjunctive General Services30% coinsurance
Vision — Eye Exams$0-$45
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$45
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)$575-$750

Service area

  • CO: 46 counties

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