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Humana USAA Honor Giveback (PPO)

H5216 - 301 - 3
3.5 out of 5 stars (3.5 / 5)

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Humana USAA Honor Giveback (PPO) is a Medicare Advantage Plan by Humana.

This page features plan details for 2025 Humana USAA Honor Giveback (PPO) H5216 – 301 – 3.

IMPORTANT: This page features the 2025 version of this plan. See the 2025 version using the link below:

2025 Humana USAA Honor Giveback (PPO) H5216 - 301 - 3

Locations

Humana USAA Honor Giveback (PPO) is offered in the following locations.

Ada County, Idaho
Adams County, Idaho
Bannock County, Idaho

Click to see more locations

Plan Overview

Humana USAA Honor Giveback (PPO) offers the following coverage and cost-sharing.

Insurer:Humana
Health Plan Deductible:$100 annual deductible
MOOP:$6,000 In and Out-of-network
$5,100 In-network
Drugs Covered:No

Ready to sign up for Humana USAA Honor Giveback (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Humana USAA Honor Giveback (PPO) qualifies for a monthly Medicare Give Back Benefit of $20.00.

Premium Reduction:$20.00

Premium Breakdown

Humana USAA Honor Giveback (PPO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.
Part B Part C Part B Give Back Total
$185.00 $0.00 $20.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Humana USAA Honor Giveback (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Prosthodontics, fixed
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Prosthodontics, removable
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply, Authorization Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply)
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply)
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply)
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply)
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: No Coins – 0.00 Copay (Limits Apply)

Diagnostic procedures/lab services/imaging

  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-360 copay (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $0-55 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $0-150 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0-55 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 50% coinsurance (Authorization Required)
    • In-Network: $0-400 copay (Authorization Required)
    • In-Network: $0-450 copay (Authorization Required)

Doctor visits

  • Specialist
    • In-Network: $50 copay per visit
  • Primary
    • In-Network: $0 copay
  • Specialist
    • In-Network: $40 copay per visit
  • Primary
    • Out-of-Network: 50% coinsurance per visit
  • Specialist
    • Out-of-Network: 50% coinsurance per visit

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $55 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • In-Network: $40 copay (Authorization Required)
    • In-Network: $50 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Routine foot care
    • Not covered

Ground ambulance

    • Out-of-Network: $315 copay
    • In-Network: $315 copay

Health plan deductible

    • $100 annual deductible

Hearing

  • Hearing aids
    • In-Network: $699-999 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $40 copay (Authorization Required)
  • Fitting/evaluation
    • In-Network: $0 copay (Authorization Required)
  • Medicare-Covered Hearing Exam
    • In-Network: $50 copay (Authorization Required)
  • Fitting/evaluation
    • Out-of-Network: $0 copay (Authorization Required)
  • Hearing aids
    • Out-of-Network: $699-999 copay (Limits Apply)
  • Hearing aids OTC
    • Not covered
  • Medicare-Covered Hearing Exam
    • Out-of-Network: 50% coinsurance (Authorization Required)

Inpatient hospital coverage

    • In-Network: $360 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • In-Network: $400 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • Out-of-Network: 50% per stay (Authorization Required)
    • In-Network: $450 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • In-Network: $425 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $6,000 In and Out-of-network
      $5,100 In-network

Medical equipment/supplies

  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • In-Network: $0 copay or 10-20% coinsurance per item (Authorization Required)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 15% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
    • In-Network: 0-19% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $360 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
    • In-Network: $450 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $0 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Inpatient hospital – psychiatric
    • Out-of-Network: 50% per stay (Authorization Required)
  • Outpatient group therapy visit
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Outpatient individual therapy visit
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Inpatient hospital – psychiatric
    • In-Network: $400 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
    • In-Network: $425 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $0 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-360 copay or 20% coinsurance per visit (Authorization Required)
    • In-Network: $0-450 copay or 20% coinsurance per visit (Authorization Required)
    • Out-of-Network: 50% coinsurance per visit (Authorization Required)
    • In-Network: $0-400 copay or 20% coinsurance per visit (Authorization Required)

Preventive care

    • Out-of-Network: $0 copay or 50% coinsurance
    • In-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: $25 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: $25 copay (Authorization Required)
    • Out-of-Network: 50% coinsurance (Authorization Required)

Skilled Nursing Facility

    • In-Network: $10 per day for days 1 through 20
      $214 per day for days 21 through 50
      $0 per day for days 51 through 100 (Authorization Required)
    • Out-of-Network: 50% per stay (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglass lenses
    • Not covered
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Other
    • Not covered
  • Routine eye exam
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglass frames
    • Not covered
  • Upgrades
    • Not covered

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Ready to sign up for Humana USAA Honor Giveback (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

For the 2025 version of Humana USAA Honor Giveback (PPO)? see 2025 Humana USAA Honor Giveback (PPO) at MedicareAdvantageRX.com.

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