Humana Value Plus H5216-382 (PPO) Medicare Advantage Plan H5216-382 • 2027 • Dickinson County, MI
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $0.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Dickinson County, MI
- Local Enrollment
- 22 beneficiaries in Dickinson County
Humana Value Plus H5216-382 (PPO) Introduction
CMS Plan ID H5216-382 identifies Humana Value Plus H5216-382, a Medicare Advantage PPO plan offered by Humana. The plan uses a Preferred Provider Organization (PPO) provider network and comes with prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $0.00.
This plan is available to eligible beneficiaries who live in Dickinson County, Michigan. CMS reports local enrollment of 22 beneficiaries for this plan in Dickinson County. New members can contact the plan at (888)873-0686 (TTY 711) for help and additional plan information.
Compare Similar Plans in Dickinson County
Compare this plan with the two most-enrolled PPO plans available in Dickinson County, Michigan. Enrollment is based on CMS local enrollment data.
| Plan Detail | Humana Value Plus H5216-382 | Humana Full Access Giveback | Humana Full Access |
|---|---|---|---|
| CMS Plan ID | H5216-382-0 |
H7617-058-0 |
H7617-052-0 |
| Local Enrollment | 22 | 587 | 450 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $500 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $9,850.00 | $5,200.00 |
| Part B Giveback | Not offered | −$99.00 reduction | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | 20% coinsurance | $50 copay | $40 copay |
| Part D Deductible | $0.00 | $150.00 | $600.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Plan Benefits
Humana Value Plus H5216-382 has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5216-382.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5216-382-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: $0 copay - Specialist
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0 copay - Telehealth benefit
- In-network: $0-$40 copay, 20% coinsurance
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: 95% coinsurance - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$325 copay, 20% coinsurance
Out-of-network: $0-$325 copay, 20% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: $0 copay - Outpatient x-rays
- In-network: $0-$40 copay, 20% coinsurance
Out-of-network: $0-$40 copay, 20% coinsurance - Diagnostic tests and procedures
- In-network: $0-$40 copay, 20% coinsurance
Out-of-network: $0-$40 copay, 20% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $110 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$2,150 per stay
Out-of-network:
$2,150 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
$0 per day for days 1-20
$218 per day for days 21-100
$0 per stay - Ground ambulance
- In-network: $325 copay
Out-of-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $35 copay
Out-of-network: $35 copay - Outpatient group therapy
- In-network: $35 copay
Out-of-network: $35 copay - Inpatient psychiatric hospital care
- In-network:
Tier 1
$2,150 per stay
Out-of-network:
$2,150 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Occupational therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay, 10%-20% coinsurance
Out-of-network: 10%-20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: $0 copay, 0%-20% coinsurance
Out-of-network: $0 copay, 20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: $0 copay - Dental x-rays
- In-network: $0 copay
Out-of-network: $0 copay - Cleaning
- In-network: $0 copay
Out-of-network: $0 copay - Periodontics
- In-network: $0 copay
Out-of-network: $0 copay - Endodontics
- In-network: $0 copay
Out-of-network: $0 copay - Restorative services
- In-network: $0 copay
Out-of-network: $0 copay - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: $0 copay
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: $0 copay - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay - Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: 95% coinsurance - Fitting/evaluation
- In-network: $0 copay
Out-of-network: 95% coinsurance - Prescription hearing aids
- In-network: $0 copay
Out-of-network: 95% coinsurance - OTC hearing aids
- In-network: $0 copay
Out-of-network: 95% coinsurance
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 Value Plus H5216-382 as a Part B benefit.
Prescription Drug Coverage
Humana Value Plus H5216-382 includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | ($31.90) |
| Supplemental Part D Premium: | $$31.90 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $6.28 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Humana starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Humana Value Plus H5216-382 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | 17% coinsurance | Coming soon |
| Non-Preferred Drug | 34% coinsurance | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H5216)
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
- New Member Part D Help
- (888)873-0686
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
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 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.