Humana Full Access H7617-069 (PPO)

EMPHESYS INSURANCE COMPANY · 2026 plan year

Plan ID H7617-069-000

Local PPO★ 4.5 CMS StarsNew for 2026
MOOP (in-network)
$3,400
MOOP (combined)
$3,400
Monthly premium
$64/mo
Part C $60.70 + Part D $3.30, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H7617-069-000
Medical deductible
$250
Part D premium
$3.30/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$615/yr
Also owed
Your Medicare Part B premium, paid separately

More EMPHESYS INSURANCE COMPANY plans in NM

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$325/day for days 1–6, $0 after
Worldwide Urgent Care Coverage$115

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
Supplemental Health BenefitsSee plan details
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$25
Mental Health — Group Sessions$25

Other

BenefitIn-network
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Skilled Nursing Facility (SNF)$0/day for days 1–20, $218/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional Sessions$20
Supervised Exercise Therapy (SET)$20
Emergency Services$115
Urgently Needed Services$65
Worldwide Emergency Transportation$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$30
Physician Specialist Services$40
Podiatry Services$40
Podiatry Services$35
Other Health Care Professional Services$0-$40
Psychiatric ServicesSee plan details
Radiological ServicesSee plan details
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Physical Therapy & Speech-Language Pathology$30
Additional Telehealth Services (Part B)$0-$65
Opioid Treatment Program Services$25-$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$100
Laboratory Services$0-$65
Diagnostic Radiology$0-$300
Therapeutic Radiology$20 copay + 20% coinsurance
X-Ray Services$0-$65
Outpatient Hospital Services$0-$325
Hospital Observation Services$325 per stay
Ambulatory Surgical Center (ASC)$0-$225
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25-$35
Diabetic Supplies & ServicesSee plan details
Substance Abuse — Group Sessions$25-$35
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$335
Air Ambulance$630
Durable Medical Equipment (DME)15% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies15% coinsurance
Diabetic Therapeutic Shoes & Inserts$10
Dialysis Services20% coinsurance
Acupuncture$40
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Vision — Routine Eye ExamsNo charge
Smoking & Tobacco Cessation CounselingNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Hearing — Prescription Hearing AidsSee plan details
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 — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)30% coinsurance
Dental — Fixed Prosthodontics (Bridges)30% coinsurance
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$40
Vision — Eye ExamsSee plan details
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 — Hearing Aids (All Types)$699-$999
Diabetic Supplies10%-20% coinsurance

Service area

  • NM: 6 counties

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