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Humana USAA Honor Giveback (PPO)

H5216 - 221 - 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 – 221 – 0 available in Select Counties in Pennsylvania and New Jersey.

Locations

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

Adams County, Pennsylvania
Allegheny County, Pennsylvania
Armstrong County, Pennsylvania

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:$6,700 In and Out-of-network
$6,700 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 $100.00.

Premium Reduction:$100.00

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 $100.00 $
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: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No 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: $0-55 copay (Authorization Required)
  • Lab services
    • In-Network: $0-55 copay (Authorization Required)
    • Out-of-Network: $0-55 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $10-105 copay (Authorization Required)
    • Out-of-Network: $10-105 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-325 copay (Authorization Required)
    • Out-of-Network: $0-325 copay (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: $0-55 copay (Authorization Required)

Doctor visits

  • Specialist
    • Out-of-Network: $45 copay per visit
  • Primary
    • In-Network: $10 copay per visit
    • Out-of-Network: $10 copay per visit
  • Specialist
    • In-Network: $45 copay 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: $45 copay (Authorization Required)
    • Out-of-Network: $45 copay (Authorization Required)
  • Routine foot care
    • Not covered

Ground ambulance

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

Health plan deductible

    • $0

Hearing

  • Hearing aids
    • Out-of-Network: $499-799 copay (Limits Apply)
  • Hearing aids OTC
    • In-Network: $0 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $45 copay (Authorization Required)
  • Fitting/evaluation
    • Out-of-Network: $0 copay (Authorization Required)
  • Hearing aids
    • In-Network: $499-799 copay (Limits Apply)
  • Hearing aids OTC
    • Out-of-Network: $0 copay (Limits Apply)
  • Fitting/evaluation
    • In-Network: $0 copay (Authorization Required)
  • Medicare-Covered Hearing Exam
    • Out-of-Network: $45 copay (Authorization Required)

Inpatient hospital coverage

    • In-Network: $425 per day for days 1 through 7
      $0 per day for days 8 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • Out-of-Network: $425 per day for days 1 through 7
      $0 per day for days 8 through 90 (Authorization Required)

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

    • $6,700 In and Out-of-network
      $6,700 In-network

Medical equipment/supplies

  • Diabetes supplies
    • Out-of-Network: 10% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 20% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 18% coinsurance per item (Authorization Required)
    • Out-of-Network: 18% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • In-Network: $0 copay or 10% coinsurance per item (Authorization Required)

Medicare Part B drugs

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

Mental health services

  • Outpatient group therapy visit
    • Out-of-Network: $40 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • In-Network: $380 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $40 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: $40 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • Out-of-Network: $380 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: $40 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: $40 copay (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • Out-of-Network: $0-800 copay per visit (Authorization Required)
    • In-Network: $0-800 copay per visit (Authorization Required)

Preventive care

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

Rehabilitation services

  • Physical therapy and speech and language therapy visit
    • In-Network: $10-40 copay (Authorization Required)
  • Occupational therapy visit
    • Out-of-Network: $10-40 copay (Authorization Required)
    • In-Network: $10-40 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: $10-40 copay (Authorization Required)

Skilled Nursing Facility

    • Out-of-Network: $10 per day for days 1 through 20
      $214 per day for days 21 through 100 (Authorization Required)
    • In-Network: $10 per day for days 1 through 20
      $214 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
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglass lenses
    • Not covered
  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply, Authorization Required)
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Other
    • Not covered
  • Upgrades
    • Not covered
  • Eyeglass frames
    • 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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