2027 Medicare Advantage plan
Humana Together in Health (PPO I-SNP): 2027 benefits and costs
Humana PPO I-SNP Special Needs Plan
CMS plan ID: H7617-138-0 · Plan year: 2027
Humana Together in Health (PPO I-SNP) is a 2027 Medicare Advantage plan offered by Humana. It is listed in Texas.
2027 plan costs at a glance
- Organization
- Humana
- Plan organization
- EMPHESYS INSURANCE COMPANY
- Parent company
- Humana Inc.
- Plan type
- PPO I-SNP
- Part C premium
- $0.00
- Part D premium
- $0.00
- Prescription drug coverage
- Yes
- Special Needs Plan type
- Institutional
- 2027 CMS Star Rating
- Standard monthly Medicare Part B premium
- $209.50 (estimated)
You must continue to pay your Medicare Part B premium.
- Annual medical deductible
- Same as Medicare's Part B deductible
Applies to out-of-network Medicare-covered services and certain in-network Medicare-covered services; out-of-network $0 preventive care is exempt.
- In-network medical maximum
- $9,850.00
Applies to certain in-network supplemental services.
- Combined in/out-of-network medical maximum
- $14,800.00
Applies to certain in-network supplemental services.
- Out-of-network medical maximum
- Not applicable
Who can join this Special Needs Plan?
This plan has institutional care eligibility requirements. The plan must confirm your qualifying care needs or living situation before you enroll.
- Plan eligibility type
- Institutional
- Institutional plan type
- Hybrid Institutional special needs plan (HI-SNP)
2027 benefit summary
Doctor visits and medical care
Plan-level deductibles may still apply when a service-specific deductible is listed as No.
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Primary care doctor | $0.00 copay
| $0.00 copay
| |
| Specialist visit | 20% coinsurance
| 20% coinsurance
|
|
| Telehealth | $0.00 copay; 20% coinsurance
| Not summarized. Check coverage with the plan. |
|
| Emergency care | $115.00 copay | Not summarized. Check coverage with the plan. | |
| Urgent care | 20% coinsurance | Not summarized. Check coverage with the plan. | |
| Home health | $0.00 copay
| $0.00 copay
|
|
| Dialysis | 20% coinsurance
| 20% coinsurance
|
|
| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
| 20% coinsurance
|
|
| Other Part B drugs | $0.00 copay; 0% to 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
| Kidney disease education services | $0.00 copay
| $0.00 copay
|
|
| Medicare-covered chiropractic | $0.00 copay
| $0.00 copay
|
|
| Medicare-covered foot care | 20% coinsurance
| 20% coinsurance
|
|
| Other health professionals | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
Hospital, outpatient surgery and observation care
Inpatient stays and skilled nursing care
| Care | Your share of the cost | What to know |
|---|---|---|
| Inpatient hospital stay | $0.00 copay per stay Days 1–4: $612.00 copay per day Days 5–90: $0.00 copay per day |
|
| Inpatient mental health care | $1,872.00 copay per stay |
|
| Skilled nursing facility | Days 1–100: $0.00 copay per day |
|
See plan documents for out-of-network hospital and skilled nursing costs.
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Outpatient hospital care | 20% coinsurance
| 20% coinsurance
| |
| Hospital observation services | 20% coinsurance
| 20% coinsurance
| |
| Ambulatory surgical center | 20% coinsurance
| 20% coinsurance
|
|
| Outpatient blood | $0.00 copay
| $0.00 copay
|
|
Tests, imaging and laboratory services
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Diagnostic procedures and tests | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
| Laboratory services | $0.00 copay
| $0.00 copay
|
|
| Diagnostic radiology (CT, MRI) | 20% coinsurance
| 20% coinsurance
|
|
| Therapeutic radiology | 20% coinsurance
| 20% coinsurance
|
|
| X-rays | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
Mental health and substance use treatment
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Partial hospitalization | 20% coinsurance
| 20% coinsurance
|
|
| Intensive outpatient program | 20% coinsurance
| 20% coinsurance
|
|
| Substance use treatment, individual sessions | 20% coinsurance
| 20% coinsurance
|
|
| Substance use treatment, group sessions | 20% coinsurance
| 20% coinsurance
|
|
| Opioid treatment program | 20% coinsurance
| 20% coinsurance
|
|
| Mental health, individual sessions | 20% coinsurance
| 20% coinsurance
|
|
| Mental health, group sessions | 20% coinsurance
| 20% coinsurance
|
|
| Psychiatry, individual sessions | 20% coinsurance
| 20% coinsurance
|
|
| Psychiatry, group sessions | 20% coinsurance
| 20% coinsurance
|
|
Therapy and rehabilitation
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Occupational therapy | $0.00 copay
| $0.00 copay
|
|
| Physical and speech therapy | $0.00 copay
| $0.00 copay
|
|
| Cardiac rehabilitation | 20% coinsurance
| 20% coinsurance
|
|
| Intensive cardiac rehabilitation | 20% coinsurance
| 20% coinsurance
|
|
| Pulmonary rehabilitation | 20% coinsurance
| 20% coinsurance
|
|
| Supervised exercise for peripheral artery disease | 20% coinsurance
| 20% coinsurance
|
|
Ambulance, medical equipment and supplies
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Ground ambulance | 20% coinsurance
| 20% coinsurance
|
|
| Air ambulance | 20% coinsurance
| 20% coinsurance
|
|
| Durable medical equipment | 20% coinsurance
| 20% coinsurance
|
|
| Prosthetic devices | 20% coinsurance
| 20% coinsurance
|
|
| Medical supplies | 20% coinsurance
| 20% coinsurance
|
|
| Diabetic supplies | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
| Diabetic shoes and inserts | $0.00 copay
| $0.00 copay
|
|
| Diabetic monitors | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
Dental benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered dental | 20% coinsurance | 20% coinsurance
| |
| Oral examsAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Dental X-raysAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Dental cleaningAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Restorative dental careAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Root canal treatment (endodontics)Additional plan benefit | $0.00 copay | $0.00 copay
| |
| Gum treatment (periodontics)Additional plan benefit | $0.00 copay | $0.00 copay
| |
| Removable dentures (prosthodontics)Additional plan benefit | $0.00 copay | $0.00 copay
| |
| Fixed dental restorations (prosthodontics)Additional plan benefit | $0.00 copay | $0.00 copay
| |
| Oral surgeryAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Other dental servicesAdditional plan benefit | $0.00 copay | $0.00 copay
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Diagnostic and preventive dental (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Comprehensive dental (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
Vision benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered eye exams | $0.00 copay; 20% coinsurance
| $0.00 copay; 20% coinsurance
|
|
| Routine eye examsAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Medicare-covered eyewear | $0.00 copay
| $0.00 copay
|
|
| Contact lensesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Eyeglasses, lenses and framesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Eye exams (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Eyewear (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
Hearing benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered hearing exams | 20% coinsurance
| 20% coinsurance
|
|
| Routine hearing examsAdditional plan benefit | $0.00 copay | 95% coinsurance
|
|
| Hearing aid fitting and evaluationAdditional plan benefit | $0.00 copay | 95% coinsurance
|
|
| Prescription hearing aids (all types)Additional plan benefit | $0.00 to $275.00 copay
| 95% coinsurance
|
|
| Over-the-counter hearing aidsAdditional plan benefit | $0.00 copay
| 95% coinsurance
|
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Hearing exams (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Prescription hearing aids (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
Extra benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Supplemental acupunctureAdditional plan benefit | 20% coinsurance
| 20% coinsurance
|
|
| Over-the-counter health itemsAdditional plan benefit | $0.00 copay
| 95% coinsurance
| |
| Annual physical examAdditional plan benefit | $0.00 copay
| $0.00 copay
|
|
Additional services and network costs
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Podiatry Services - Routine Foot CareAdditional plan benefit | Out-of-network | $0.00 copay
|
|
| Medicare-covered preventive servicesMedicare-covered care | Out-of-network | $0.00 copay
| |
| Glaucoma ScreeningMedicare-covered care | Out-of-network | $0.00 copay
| |
| Diabetes Self-Management TrainingMedicare-covered care | Out-of-network | $0.00 copay
| |
| Digital Rectal ExamsMedicare-covered care | Out-of-network | $0.00 copay
| |
| EKG after a Welcome to Medicare visitMedicare-covered care | Out-of-network | $0.00 copay
| |
| Medicare Part B insulinMedicare-covered care | Out-of-network | $0.00 copay; 20% coinsurance
|
Allowances and optional benefits
OTC Max Allowance
One shared limit covers the listed services, not a separate allowance for each service.
- Services sharing this allowance
- Over-the-counter health items; Over-the-counter hearing aids
- How benefits are provided
- Catalogue Purchase
- Advance choice of benefits required
- No
- Shared benefit limit
- $30.00
- How often this limit applies
- Every one month
- Shared limit on visits or trips
- No
Benefits for qualifying members
Chronic Condition Care Assistance
The plan must confirm eligibility, including any qualifying condition.
- Qualifying conditions
- Chronic alcohol use disorder and other substance use disorders (SUDs); Autoimmune disorders; Cancer; Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; Chronic kidney disease (CKD); Severe hematologic disorders; HIV/AIDS; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Post-organ transplantation
- To qualify
- Participation in a Care Management Program
- Covered package services cost $0 until the package limit is reached
- Yes
- Applies to out-of-network or point-of-service care
- No
- Package limit
- $500.00
- How benefits are provided
- Other
- How to use the benefit
- Purchases must be coordinated by a care manager on the member's behalf.
Full package terms are not summarized here.
Chronic Care Assistance and Music Therapy
The plan must confirm eligibility, including any qualifying condition.
- Qualifying conditions
- Chronic alcohol use disorder and other substance use disorders (SUDs); Autoimmune disorders; Cancer; Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; Chronic kidney disease (CKD); Severe hematologic disorders; HIV/AIDS; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Post-organ transplantation
- To qualify
- Participation in a Care Management Program
- Included services
- Transportation to plan-approved health locations; Over-the-counter health items; Transportation for non-medical needs; Social support benefit; Support for daily living; Wigs for chemotherapy-related hair loss; Alternative Therapies; Eyeglasses (lenses and frames); Eyeglass lenses; Eyeglass frames; Prescription Hearing Aids (all types); Over-the-counter hearing aids
- Applies to out-of-network or point-of-service care
- Yes
- Some package benefits are exempt from the deductible
- Yes
- Services exempt from the deductible
- Transportation to plan-approved health locations; Over-the-counter health items; Transportation for non-medical needs; Social support benefit; Support for daily living; Wigs for chemotherapy-related hair loss; Alternative Therapies; Eyeglasses (lenses and frames); Eyeglass lenses; Eyeglass frames; Prescription Hearing Aids (all types); Over-the-counter hearing aids
- Package limit
- $500.00
- How often this limit applies
- Every year
- How benefits are provided
- Other
- How to use the benefit
- Purchases must be coordinated by a care manager on the member's behalf.
- Services sharing the package limit
- Transportation to plan-approved health locations; Over-the-counter health items; Transportation for non-medical needs; Social support benefit; Support for daily living; Wigs for chemotherapy-related hair loss; Eyeglasses (lenses and frames); Eyeglass lenses; Eyeglass frames; Prescription Hearing Aids (all types); Over-the-counter hearing aids
Full package terms are not summarized here.
Prescription drug coverage
Costs shown are for initial coverage.
Drug deductible exceptions: Tier 1; Tier 2; Tier 3 are exempt from the deductible.
Standard retail costs
| Drug tier | 30 days | 100 days |
|---|---|---|
| Tier 1Preferred Generic | $0.00 | $0.00 |
| Tier 2Generic | $0.00 | $0.00 |
| Tier 3Preferred Brand | 10% | 10% |
| Tier 4Non-Preferred Drug | 30% | 30% |
| Tier 5Specialty Tier | 30% | Not listed |
Mail-order and other pharmacies
Out-of-network pricing: You pay the standard retail copay or coinsurance, plus any difference between the pharmacy’s billed charge and the amount the plan allows at a standard retail pharmacy.
Preferred mail order costs
| Drug tier | 30 days | 100 days |
|---|---|---|
| Tier 1Preferred Generic | $0.00 | $0.00 |
| Tier 2Generic | $0.00 | $0.00 |
| Tier 3Preferred Brand | 10% | 10% |
| Tier 4Non-Preferred Drug | 30% | 30% |
| Tier 5Specialty Tier | 30% | Not listed |
Standard mail order costs
| Drug tier | 30 days | 100 days |
|---|---|---|
| Tier 1Preferred Generic | $10.00 | $30.00 |
| Tier 2Generic | $20.00 | $60.00 |
| Tier 3Preferred Brand | 10% | 10% |
| Tier 4Non-Preferred Drug | 30% | 30% |
| Tier 5Specialty Tier | 30% | Not listed |
Long-term care pharmacy costs
| Drug tier | 31 days |
|---|---|
| Tier 1Preferred Generic | $0.00 |
| Tier 2Generic | $0.00 |
| Tier 3Preferred Brand | 10% |
| Tier 4Non-Preferred Drug | 30% |
| Tier 5Specialty Tier | 30% |
Out-of-network pharmacy costs
| Drug tier | 30 days |
|---|---|
| Tier 1Preferred Generic | $0.00 |
| Tier 2Generic | $0.00 |
| Tier 3Preferred Brand | 10% |
| Tier 4Non-Preferred Drug | 30% |
| Tier 5Specialty Tier | 30% |
Drug coverage rules and exceptions
Tier 1: Preferred Generic
- Drugs included in this tier
- Part D Drugs Only
- Longer fills available for every covered drug
- Yes
- Some longer-fill prescriptions require a one-month first fill
- No
Tier 2: Generic
- Drugs included in this tier
- Part D Drugs Only
- Longer fills available for every covered drug
- No
- Some longer-fill prescriptions require a one-month first fill
- No
Tier 3: Preferred Brand
- Drugs included in this tier
- Part D Drugs Only
- Longer fills available for every covered drug
- No
- Some longer-fill prescriptions require a one-month first fill
- No
Tier 4: Non-Preferred Drug
- Drugs included in this tier
- Part D Drugs Only
- Longer fills available for every covered drug
- No
- Some longer-fill prescriptions require a one-month first fill
- No
Tier 5: Specialty Tier
- Drugs included in this tier
- Part D Drugs Only
- Initial-coverage prices also apply to drugs exempt from the deductible
- Yes
Special cost protections apply to covered insulin and recommended adult vaccines.
Where this plan is offered
CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.
View all locations 199 county listings across 1 state or territory
Texas
- Anderson, Texas
- Andrews, Texas
- Angelina, Texas
- Aransas, Texas
- Archer, Texas
- Armstrong, Texas
- Atascosa, Texas
- Austin, Texas
- Bandera, Texas
- Bastrop, Texas
- Baylor, Texas
- Bee, Texas
- Bexar, Texas
- Blanco, Texas
- Bosque, Texas
- Bowie, Texas
- Brazoria, Texas
- Brooks, Texas
- Brown, Texas
- Burleson, Texas
- Burnet, Texas
- Caldwell, Texas
- Calhoun, Texas
- Callahan, Texas
- Cameron, Texas
- Camp, Texas
- Carson, Texas
- Cass, Texas
- Castro, Texas
- Chambers, Texas
- Cherokee, Texas
- Clay, Texas
- Coke, Texas
- Coleman, Texas
- Collin, Texas
- Colorado, Texas
- Comal, Texas
- Comanche, Texas
- Concho, Texas
- Cooke, Texas
- Coryell, Texas
- Crosby, Texas
- Dallas, Texas
- Dawson, Texas
- Deaf Smith, Texas
- Delta, Texas
- Denton, Texas
- DeWitt, Texas
- Dickens, Texas
- Dimmit, Texas
- Duval, Texas
- Eastland, Texas
- Ector, Texas
- Edwards, Texas
- El Paso, Texas
- Ellis, Texas
- Erath, Texas
- Falls, Texas
- Fannin, Texas
- Fayette, Texas
- Fort Bend, Texas
- Franklin, Texas
- Freestone, Texas
- Frio, Texas
- Galveston, Texas
- Garza, Texas
- Gillespie, Texas
- Goliad, Texas
- Gonzales, Texas
- Gray, Texas
- Grayson, Texas
- Gregg, Texas
- Grimes, Texas
- Guadalupe, Texas
- Hale, Texas
- Hall, Texas
- Hamilton, Texas
- Hardin, Texas
- Harris, Texas
- Harrison, Texas
- Hartley, Texas
- Haskell, Texas
- Hays, Texas
- Henderson, Texas
- Hidalgo, Texas
- Hill, Texas
- Hockley, Texas
- Hood, Texas
- Hopkins, Texas
- Houston, Texas
- Howard, Texas
- Hudspeth, Texas
- Hunt, Texas
- Hutchinson, Texas
- Irion, Texas
- Jack, Texas
- Jackson, Texas
- Jasper, Texas
- Jefferson, Texas
- Jim Hogg, Texas
- Jim Wells, Texas
- Johnson, Texas
- Jones, Texas
- Karnes, Texas
- Kaufman, Texas
- Kendall, Texas
- Kenedy, Texas
- Kerr, Texas
- Kinney, Texas
- Kleberg, Texas
- Lamar, Texas
- Lamb, Texas
- Lampasas, Texas
- Lavaca, Texas
- Lee, Texas
- Leon, Texas
- Liberty, Texas
- Limestone, Texas
- Live Oak, Texas
- Llano, Texas
- Lubbock, Texas
- Lynn, Texas
- Madison, Texas
- Marion, Texas
- Martin, Texas
- Matagorda, Texas
- Maverick, Texas
- McCulloch, Texas
- McLennan, Texas
- Medina, Texas
- Midland, Texas
- Milam, Texas
- Mills, Texas
- Montague, Texas
- Montgomery, Texas
- Moore, Texas
- Morris, Texas
- Nacogdoches, Texas
- Navarro, Texas
- Newton, Texas
- Nolan, Texas
- Nueces, Texas
- Orange, Texas
- Palo Pinto, Texas
- Panola, Texas
- Parker, Texas
- Pecos, Texas
- Polk, Texas
- Potter, Texas
- Rains, Texas
- Randall, Texas
- Real, Texas
- Red River, Texas
- Reeves, Texas
- Refugio, Texas
- Robertson, Texas
- Rockwall, Texas
- Runnels, Texas
- Rusk, Texas
- Sabine, Texas
- San Augustine, Texas
- San Jacinto, Texas
- San Patricio, Texas
- San Saba, Texas
- Schleicher, Texas
- Shackelford, Texas
- Shelby, Texas
- Smith, Texas
- Somervell, Texas
- Starr, Texas
- Stephens, Texas
- Tarrant, Texas
- Terry, Texas
- Throckmorton, Texas
- Titus, Texas
- Tom Green, Texas
- Travis, Texas
- Trinity, Texas
- Tyler, Texas
- Upshur, Texas
- Uvalde, Texas
- Val Verde, Texas
- Van Zandt, Texas
- Victoria, Texas
- Walker, Texas
- Waller, Texas
- Ward, Texas
- Washington, Texas
- Webb, Texas
- Wharton, Texas
- Wilbarger, Texas
- Willacy, Texas
- Williamson, Texas
- Wilson, Texas
- Wise, Texas
- Wood, Texas
- Young, Texas
- Zapata, Texas
- Zavala, Texas
