Humana USAA Honor Giveback (HMO) Medicare Advantage Plan H5619-121 • 2027 • San Bernardino County, CA
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $5250.00In-network
- Part B Giveback
- −$45.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- San Bernardino County, CA
- Local Enrollment
- 138 beneficiaries in San Bernardino County
Humana USAA Honor Giveback (HMO) Introduction
This Medicare Advantage HMO plan, Humana USAA Honor Giveback, is offered by Humana and uses a Health Maintenance Organization (HMO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $5250.00. The plan is identified by CMS Plan ID H5619-121.
Enrollment in this plan requires residence in San Bernardino County, California. CMS enrollment data reports 138 plan members in San Bernardino County. New members can call the plan directly at (888)873-0686 (TTY 711) for assistance.
Compare Similar Plans in San Bernardino County
Compare this plan with the two most-enrolled HMO plans available in San Bernardino County, California. Enrollment is based on CMS local enrollment data.
| Plan Detail | Humana USAA Honor Giveback | Kaiser Permanente Senior Advantage Inland Empire | SCAN Classic |
|---|---|---|---|
| CMS Plan ID | H5619-121-0 |
H0524-015-0 |
H5425-009-0 |
| Local Enrollment | 138 | 42,617 | 24,601 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $5,250.00 | $2,500.00 | $399.00 |
| Part B Giveback | −$45.00 reduction | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $10 copay | $0 copay | $0 copay |
| Part D Deductible | Not Applicable | $0.00 | $370.00 |
| CMS Star Rating | 4.0 | 4.5 | 4.0 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | Not covered | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in San Bernardino County, or compare Medicare Advantage plans across California, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for Humana USAA Honor Giveback includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H5619-121.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5619-121-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $10 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$50 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$345 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0-$145 copay
- Diagnostic tests and procedures
- In-network: $0-$175 copay
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $50 copay
- Inpatient hospital care
- Tier 1
$340 per day for days 1-6
$0 per day for days 7-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$10 per day for days 1-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
- Outpatient group therapy
- In-network: $0 copay
- Inpatient psychiatric hospital care
- Tier 1
$340 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay, 10% coinsurance
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: $0 copay
- Endodontics
- Not covered
- Restorative services
- In-network: $25 copay
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $575-$750 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Humana USAA Honor Giveback as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H5619)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Humana
- Website
- Humana Plan Page
- Providers
- Humana Providers Page
- Formulary
- Humana Formulary Page
- Pharmacy
- Humana Pharmacy Page
- New Member Health Plan Help
- (888)873-0686
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Humana USAA Honor Giveback is available to eligible Medicare beneficiaries residing in San Bernardino County, California, including communities such as Rancho Cucamonga, Chino, Chino Hills, Ontario, Montclair, Upland, Earp, Joshua Tree, Morongo Valley, Twentynine Palms, Yucca Valley, Landers, Adelanto, Apple Valley, Fort Irwin, Barstow, Grand Terrace, Big Bear City, Big Bear Lake, Bloomington, Cedar Glen, Colton, Crestline, Fontana, Helendale, Hesperia, Highland, Hinkley, Lake Arrowhead, Loma Linda, Lucerne Valley, Mentone, Needles, Newberry Springs, Phelan, Pinon Hills, Redlands, Rialto, Running Springs, Sugarloaf, Twin Peaks, Victorville, Wrightwood, Yucaipa, San Bernardino, Trona, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Humana (official source) | http://www.humana.com/medicare | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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