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Humana USAA Honor Giveback (PPO) Medicare Advantage Plan H5216-455 • 2027

CMS Rating: ☆☆☆☆☆ (4.0 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$5100.00In-network
Part B Giveback
−$43.00 reduction
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
4,614 beneficiaries
Last update:

Humana USAA Honor Giveback (PPO) Introduction

This Medicare Advantage PPO plan, Humana USAA Honor Giveback, is offered by Humana and uses a Preferred Provider Organization (PPO) 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 $5100.00. The plan is identified by CMS Plan ID H5216-455.

Plan Benefits

Humana USAA Honor Giveback includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H5216-455.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $0 copay
Out-of-network: 50% coinsurance		 In-network: $0 copay
Out-of-network: 50% coinsurance
Specialist In-network: $40 copay
Out-of-network: 50% coinsurance		 In-network: $40 copay
Out-of-network: 50% coinsurance

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Telehealth benefit In-network: $0-$50 copay In-network: $0-$50 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon In-network: $0 copay
Out-of-network: $0 copay
Health education Not covered Not covered
Counseling services Not covered Not covered
Over-the-counter drug benefits Not covered In-network: $0 copay
Out-of-network: $0 copay
Health transportation (non-emergency) Coming soon Not covered

Diagnostic, Lab, and Imaging Services

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: $0-$345 copay
Out-of-network: $0 copay, 50% coinsurance		 In-network: $0-$780 copay
Out-of-network: $0 copay, 50% coinsurance
Lab services In-network: $0 copay
Out-of-network: $50 copay, 50% coinsurance		 In-network: $0-$50 copay
Out-of-network: 50% coinsurance
Outpatient x-rays In-network: $0-$145 copay
Out-of-network: $50 copay, 50% coinsurance		 In-network: $0-$130 copay
Out-of-network: 50% coinsurance
Diagnostic tests and procedures In-network: $0-$100 copay
Out-of-network: $50 copay, 50% coinsurance		 In-network: $0-$50 copay
Out-of-network: 50% coinsurance

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $130 copay $130 copay
Worldwide emergency care Coming soon $130 copay
Urgent care $50 copay $50 copay
Inpatient hospital care In-network:
Tier 1
$480 per day for days 1-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
50% per stay		 In-network:
Tier 1
$480 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
50% per stay
Skilled Nursing Facility In-network:
Tier 1
$10 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
50% per stay		 In-network:
Tier 1
$10 per day for days 1-20
$218 per day for days 21-70
$0 per day for days 71-100
Out-of-network:
50% per stay
Ground ambulance In-network: $325 copay
Out-of-network: $325 copay		 In-network: $305 copay
Out-of-network: $305 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $0 copay
Out-of-network: 50% coinsurance		 In-network: $0 copay
Out-of-network: 50% coinsurance
Outpatient group therapy In-network: $0 copay
Out-of-network: 50% coinsurance		 In-network: $0 copay
Out-of-network: 50% coinsurance
Inpatient psychiatric hospital care In-network:
Tier 1
$480 per day for days 1-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
50% per stay		 In-network:
Tier 1
$480 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
50% per stay

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: $45 copay
Out-of-network: 50% coinsurance		 In-network: $25 copay
Out-of-network: 50% coinsurance
Occupational therapy In-network: $45 copay
Out-of-network: 50% coinsurance		 In-network: $25 copay
Out-of-network: 50% coinsurance

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: $0 copay, 10%-20% coinsurance
Out-of-network: 50% coinsurance		 In-network: $0 copay, 10%-20% coinsurance
Out-of-network: 50% coinsurance
Durable medical equipment In-network: 20% coinsurance
Out-of-network: 50% coinsurance		 In-network: $0 copay, 20% coinsurance
Out-of-network: 50% coinsurance
Prosthetics In-network: 20% coinsurance
Out-of-network: 50% coinsurance		 In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance		 In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Other Part B drugs (Medicare-covered) In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance		 In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Cleaning In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Periodontics In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Endodontics In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Restorative services In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Implant services Not covered Not covered
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
Covered Service 2027 2026
Routine eye exam In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Contact lenses In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames only Not covered Not covered
Eyeglass lenses only Not covered Not covered
Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Upgrades Not covered Not covered

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
Covered Service 2027 2026
Hearing exam In-network: $0 copay
Out-of-network: 95% coinsurance		 In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation In-network: $0 copay
Out-of-network: 95% coinsurance		 In-network: $0 copay
Out-of-network: $0 copay
Prescription hearing aids In-network: $575-$750 copay
Out-of-network: 95% coinsurance		 In-network: $699-$999 copay
Out-of-network: $699-$999 copay
OTC hearing aids Not covered In-network: $0 copay
Out-of-network: $0 copay

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
Covered Service 2027 2026
Adult day health services Not covered Not covered
Home-based palliative care Not covered Not covered
Personal emergency response system Coming soon Not covered
Weight management programs Not covered Not covered
Wigs for chemotherapy-related hair loss Coming soon Not covered
Alternative therapies Not covered Not covered
Massage therapy Not covered Not covered
Home/bathroom safety devices Not covered 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: 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.

2027 Medicare Star Ratings for Contract H5216
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 ☆☆☆☆☆

Plan Availability

Humana USAA Honor Giveback (H5216-455-0) is available in the following locations:

Idaho Counties Served
Oregon Counties Served
Utah Counties Served
Washington Counties Served

Frequently Asked Questions

Here are some of the most frequently asked questions about this plan (click to open).

Frequently Asked Questions About Humana USAA Honor Giveback (PPO)

Is there a monthly premium for this plan in 2027?

For 2027, the monthly premium is $0.00. Medicare Part B premiums apply in addition to this amount.

What is the in-network MOOP for plan H5216-455?

For 2027, the in-network maximum out-of-pocket is $5100.00. The plan pays 100% of covered in-network services beyond this amount.

What is the total enrollment for plan H5216-455?

Total enrollment is 4,614 beneficiaries based on the latest CMS data.

Is there a Part D deductible for this plan?

The Part D deductible is $0.00.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
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
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Your 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.