Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

HumanaChoice: Diabetes and Heart, 2027

H5216Contract375Plan

PPO C-SNP · special needs plan, chronic or disabling condition · 47 counties in Michigan

Run by Humana Insurance Company (contract H5216), sold as Humana, owned by Humana Inc.

Renews for 2027

2026 star rating, contract H5216: 3.5 of 5

HumanaChoice: Diabetes and Heart (H5216-375) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $6,950 ($6,550 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
In-network out-of-pocket limit	$6,550	$6,950	up $400
Drug deductible	$300	$400	up $100
Ground ambulance, in network	$335 copay	$325 copay	down $10
Eyewear, yearly limit	$250 a year	$100 a year	down $150
Drug tier 2, generic	$10	$0	down $10
Drug tier 3, preferred brand	$47	17% of the cost	changed
Drug tier 4, non-preferred drug	47% of the cost	50% of the cost	up 3 points
15 lines do not change
Monthly premium	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$40 copay	$40 copay	no change
Emergency room	$130 copay	$130 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$530 a day for days 1–5, then $0 a day for days 6–90	$530 a day for days 1–5, then $0 a day for days 6–90	no change
Skilled nursing facility, in network	$10 a day for days 1–20, then $218 a day for days 21–100	$10 a day for days 1–20, then $218 a day for days 21–100	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	not offered	not offered	no change
Counties served	47	47	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 5, specialty tier	29% of the cost	29% of the cost	no change
Drug tier 6, select care drugs	$0	$0	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	$10	$0
Tier 3	Preferred Brand	$47	17% of the cost
Tier 4	Non-Preferred Drug	47% of the cost	50% of the cost
Tier 5	Specialty Tier	29% of the cost	29% of the cost
Tier 6	Select Care Drugs	$0	$0

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 17 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 7 plans have a lower out-of-pocket limit, 2 the same, 7 a higher one. On the premium, 14 the same, 2 a higher one.

Out-of-pocket limits of the 17 chronic or disabling condition special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0002 plans

$6,000 to under $8,000 (this plan)10 plans

$8,000 to $10,0005 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 47 counties: $0 a month and $6,950.

Michigan

Allegan Arenac Barry Bay Berrien Branch Calhoun Cass Clare Clinton Eaton Genesee Gladwin Gratiot Hillsdale Huron Ingham Ionia Isabella Jackson Kalamazoo Kent Lake Lapeer Lenawee Livingston Macomb Mason Mecosta Midland Monroe Montcalm Muskegon Newaygo Oakland Oceana Osceola Ottawa Saginaw Sanilac Shiawassee St. Clair St. Joseph Tuscola Van Buren Washtenaw Wayne

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID: H5216-375
Legal name of the contract: Humana Insurance Company
Sold as: Humana
Parent company: Humana Inc.
Plan type: PPO C-SNP
2026 star rating of the contract: 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3 of 5
Members, September 2026: 10,720
Plan website, as filed with CMS: www.humana.com/medicare

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Wayne, MIWhere most of its members live; premiums and limits side by side
Every Humana plan for 2027Its contracts, counties and plans that end
The other 212 plans of contract H5216Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.