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Medicare Advantage · Local PPO
Humana
Plan year 2026
Humana Together in Health Select (PPO I-SNP) H5216-453
Monthly premium
$138
+ your Part B premium
Max out-of-pocket
$4,900
in-network annual cap
Primary care
$0
per visit copay
Specialist
20%
per visit
Medical coverage is different from long-term room and board
An I-SNP coordinates Medicare-covered care for members who meet its institutional eligibility rules. That eligibility does not mean Medicare pays for long-term custodial care or an ongoing nursing-home stay. Medicare may cover short-term skilled nursing care when its coverage requirements are met; Medicaid, long-term-care insurance, or personal funds may cover other long-term-care costs.
The nursing-home finder shows CMS facility information. It does not confirm that a facility participates in this plan. Confirm participation with both the facility and the plan before enrolling.
Your costs at a glanceIn-network, for the 2026 plan year
Rx deductible
$300
Inpatient hospital
Days 1-4: $687/day, Days 5-90: $0/day, then $0/day
no limit on covered hospital days
Inpatient mental health
$1,872
per stay
Outpatient surgery
20%
Emergency room
$130
Urgent care
20% (max $50/visit)
What's included, and what it's actually worth4 benefits included. Tap any card for the detail
Dental
$1,000/yr allowance
Annual max$1,000/yr allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Vision
$250/yr eyewear allowance
Eyewear allowance$250/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
Doctor Visits: Specialist20%
Inpatient Hospital$687/day, days 1–4
Outpatient Surgery20%
Mental Health$1,872 per stay
Hearing$0–$599
MealsMeal benefit
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Tier 1
$2
Preferred Generic
Tier 2
$4
Generic
Tier 3
$47
Preferred Brand· after deductible
Tier 4
25%
Non-Pref Brand· after deductible
Tier 5
29%
Specialty· after deductible
Our take
Where this plan shines
This plan’s out-of-pocket maximum is below the national median.
See your primary doctor for $0.
Things to know before you enroll
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)
Plan documents
Summary of Benefits (PDF)
Download the plan's official Summary of Benefits document
Evidence of Coverage (PDF)
Complete plan details and rules
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (888)873-0686 (TTY: 711) para solicitar documentos en español