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Humana USAA Honor Giveback (PPO)

H5216 - 059 - 0
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 – 059 – 0 available in ME and NH. Select Counties in CT, MA, and VT.

Locations

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

Androscoggin County, Maine
Aroostook County, Maine
Belknap County, New Hampshire

Click to see more locations

Plan Overview

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

Insurer:Humana
Health Plan Deductible:$0
MOOP:$8,950 In and Out-of-network
$4,950 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 $75.00.

Premium Reduction:$75.00

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 $75.00 $
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 (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: 30-40 Coins – 0.00 Copay (Authorization Required)
  • Restorative Services
    • In-Network: 30-40 Coins – 0.00 Copay (Authorization Required)

Diagnostic and Preventive Dental

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

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • In-Network: $0-90 copay (Authorization Required)
  • Lab services
    • Out-of-Network: $20-65 copay or 30% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: $20-65 copay or 30% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0-55 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $0-90 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: $65 copay or 30% coinsurance (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: $20-65 copay or 30% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $40-350 copay (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: $20 copay per visit
  • Specialist
    • Out-of-Network: $65 copay per visit
  • Primary
    • In-Network: $0 copay
  • Specialist
    • In-Network: $40 copay per visit

Emergency care/Urgent care

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

Foot care (podiatry services)

  • Foot exams and treatment
    • In-Network: $40 copay (Authorization Required)
  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • Out-of-Network: $65 copay (Authorization Required)

Ground ambulance

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

Health plan deductible

    • $0

Hearing

  • Hearing aids
    • In-Network: $199-499 copay (Limits Apply)
    • Out-of-Network: $199-499 copay (Limits Apply)
  • Fitting/evaluation
    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: $0 copay (Authorization Required)
  • Hearing aids OTC
    • Out-of-Network: $0 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $40 copay (Authorization Required)
  • Hearing aids OTC
    • In-Network: $0 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • Out-of-Network: $65 copay (Authorization Required)

Inpatient hospital coverage

    • Out-of-Network: 20% per stay (Authorization Required)
    • In-Network: $460 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)

    • $8,950 In and Out-of-network
      $4,950 In-network

Medical equipment/supplies

  • Diabetes supplies
    • In-Network: $0 copay or 10% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • Out-of-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 30% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • Out-of-Network: 30% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $420 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Inpatient hospital – psychiatric
    • Out-of-Network: 20% per stay (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $40-525 copay per visit (Authorization Required)
    • Out-of-Network: $65 copay or 30% coinsurance per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: 30% coinsurance (Authorization Required)
    • In-Network: $40 copay (Authorization Required)

Skilled Nursing Facility

    • Out-of-Network: 30% per stay (Authorization Required)
    • In-Network: $0 per day for days 1 through 20
      $196 per day for days 21 through 100 (Authorization Required)

Transportation

    • In-Network: $0 copay (Limits Apply, Authorization Required)
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)

Vision

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

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Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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