Home›2027 Medicare plans›Pennsylvania›HumanaChoice SNP-DE H5216-227 (PPO D-SNP)

HumanaChoice SNP-DE H5216-227 (PPO D-SNP) (2027)

Dual Special Needs Plan (Medicare Advantage) from Humana, plan ID H5216-227-000. Sold in 36 counties in Pennsylvania.

★★★★★4.0

Who can join

Only for people who have both Medicare and Medicaid.

2027 costs

Monthly premium$0
Drug deductible$700
Medical deductible$0
Out-of-pocket maximum (in network)$9,850
Plan typeDual Special Needs Plan (Medicare Advantage), PPO
Referral needed to see a specialistNo
Plan IDH5216-227-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium, unless Medicaid pays it for you.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit20%
Specialist visit20%
Preventive care$0
Urgent care$40
Emergency room$115
Hospital stay$0
Outpatient surgery$0
Lab tests$0–$40
X-rays and scans$0
Mental health visit20%
Physical therapy20%
Medical equipment20%
TelehealthCovered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $750 allowance
VisionCovered — up to $100/yr allowance
HearingCovered — $0 copay per aid
Over-the-counter itemsCovered
FitnessNot covered
Rides to appointmentsNot covered

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic$0$0$0
2 Generic$0$0$0
3 Preferred Brand17%17%17%
4 Non-Preferred Drug43%43%43%
5 Specialty Tier25%25%N/A

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Where it's sold

Pennsylvania (36 counties)

Other 2027 Humana plans in Pennsylvania

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.