Humana USAA Honor Giveback (PPO) Medicare Advantage Plan H7617-022 • 2027 • Burnett County, WI
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $100
- Maximum Out-of-Pocket
- $6000.00In-network
- Part B Giveback
- −$150.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Burnett County, WI
- Local Enrollment
- 71 beneficiaries in Burnett County
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 $100, and the in-network maximum out-of-pocket is $6000.00. The plan is identified by CMS Plan ID H7617-022.
Enrollment in this plan requires residence in Burnett County, Wisconsin. CMS enrollment data reports 71 plan members in Burnett County. New members can call the plan directly at (888)873-0686 (TTY 711) for assistance.
Compare Similar Plans in Burnett County
Compare this plan with the two most-enrolled PPO plans available in Burnett County, Wisconsin. Enrollment is based on CMS local enrollment data.
| Plan Detail | Humana USAA Honor Giveback | HumanaChoice H7617-007 | Humana USAA Honor Giveback |
|---|---|---|---|
| CMS Plan ID | H7617-022-0 |
H7617-007-0 |
H5216-355-0 |
| Local Enrollment | 71 | 129 | 52 |
| Monthly Premium | $0.00 | $60.00 | $0.00 |
| Medical Deductible | $100 | $0.00 | $100 |
| Maximum Out-of-Pocket | $6,000.00 | $9,250.00 | $6,000.00 |
| Part B Giveback | −$150.00 reduction | Not offered | −$150.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $45 copay | $50 copay | $45 copay |
| Part D Deductible | Not Applicable | $700.00 | Not Applicable |
| 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 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 H7617-022.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H7617-022-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: 45% coinsurance - Specialist
- In-network: $45 copay
Out-of-network: 45% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-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
- 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-$345 copay
Out-of-network: $0 copay, 50% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: $50 copay, 50% coinsurance - Outpatient x-rays
- In-network: $0-$145 copay
Out-of-network: $50 copay, 45%-50% coinsurance - Diagnostic tests and procedures
- In-network: $0-$100 copay
Out-of-network: $50 copay, 45%-50% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $50 copay
- Inpatient hospital care
- In-network:
Tier 1
$295 per day for days 1-6
$0 per day for days 7-90
$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 - Ground ambulance
- In-network: $325 copay
Out-of-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
Out-of-network: 45% coinsurance - Outpatient group therapy
- In-network: $0 copay
Out-of-network: 45% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$295 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Out-of-network:
50% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $40 copay
Out-of-network: 45% coinsurance - Occupational therapy
- In-network: $40 copay
Out-of-network: 45% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay, 10%-20% coinsurance
Out-of-network: 10%-50% coinsurance - Durable medical equipment
- In-network: 18% coinsurance
Out-of-network: 50% coinsurance - Prosthetics
- In-network: 18% coinsurance
Out-of-network: 50% coinsurance
Medicare Part B Drugs
- Chemotherapy
- 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
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: $575-$750 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 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: H7617)
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 | Not enough data available |
| 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 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 |
| 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.
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.