Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026
HumanaChoice is not offered under this ID in 2027
H5216Contract395Plan
PPO · served 16 counties in Ohio, West Virginia in 2026
Run by Humana Insurance Company (contract H5216), sold as Humana, owned by Humana Inc.
CMS crosswalk: members move into H5216-425 in 14 of its 16 counties; in the others the plan ends
HumanaChoice (H5216-395) is not offered under this ID in 2027. The CMS plan crosswalk of October 1, 2026 moves its members into HumanaChoice (H5216-425), in the 14 counties where that plan is sold (774 members in September 2026). In its other 2 counties (140 members) there is no plan to move into: coverage ends December 31, 2026, and members there need to choose a new plan.
What changes for its members in HumanaChoice?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $17 | $29 | ▲up $12 |
| In-network out-of-pocket limit | $6,550 | $7,600 | ▲up $1,050 |
| Drug deductible | $400 | $700 | ▲up $300 |
| Specialist visit | $55 copay | $40 copay | ▼down $15 |
| Emergency room | $125 copay | $115 copay | ▼down $10 |
| Hospital stay, in network | $440 a day for days 1–5, then $0 a day for days 6–90 | $380 a day for days 1–7, then $0 a day for days 8–90 | ▼down $300for a 5-day stay |
| Skilled nursing facility, in network | $10 a day for days 1–20, then $214 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▼down $130for a 30-day stay |
| Ground ambulance, in network | $315 copay | $325 copay | ▲up $10 |
| Counties served | 16 | 55 | ▲up 39 |
| Drug tier 3, preferred brand | $47 | 17% of the cost | changed |
| Drug tier 5, specialty tier | 28% of the cost | 25% of the cost | ▼down 3 points |
| 10 lines do not change | |||
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Medical deductible, in network | none | none | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | $100 a year | $100 a year | 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 |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, generic | $5 | $5 | no change |
| Drug tier 4, non-preferred drug | 50% of the cost | 50% of the cost | no change |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); 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. Your plan's Annual Notice of Change is the letter that confirms your 2027 plan; confirm on Medicare Plan Finder.
What can members do, and by when?
If you live in Calhoun (WV), Doddridge (WV), Harrison (WV), Jackson (WV), Marion (WV), Marshall (WV), Monongalia (WV), Ohio (WV), Pleasants (WV), Ritchie (WV), Tyler (WV), Wetzel (WV), Wirt (WV), Wood (WV)
- If you do nothing
- You are moved into HumanaChoice on January 1, 2027.
- October 15 to December 7, 2026
- Open enrollment: choose another Medicare Advantage plan, or Original Medicare with a drug plan, instead.
If you live in Belmont (OH), Monroe (OH)
- Your coverage
- Ends December 31, 2026: HumanaChoice is not sold where you live.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
- Without a drug plan
- Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
Source: Medicare.gov, “Special enrollment periods” and “Joining a plan” (read Oct. 7, 2026).
Where did its members live?
Where its members lived in September 2026; each county and state page lists the 2027 plans sold there.
| County | Members, Sept. 2026 | For 2027 |
|---|---|---|
| Wood, WV | 231 | moves into H5216-425 |
| Harrison, WV | 131 | moves into H5216-425 |
| Belmont, OH | 108 | plan ends here |
| Ohio, WV | 67 | moves into H5216-425 |
| Jackson, WV | 62 | moves into H5216-425 |
| Monongalia, WV | 51 | moves into H5216-425 |
| Marshall, WV | 46 | moves into H5216-425 |
| Wetzel, WV | 40 | moves into H5216-425 |
| Monroe, OH | 32 | plan ends here |
| Tyler, WV | 27 | moves into H5216-425 |
| Ritchie, WV | 26 | moves into H5216-425 |
| Marion, WV | 25 | moves into H5216-425 |
| Pleasants, WV | 19 | moves into H5216-425 |
| Doddridge, WV | 18 | moves into H5216-425 |
| Wirt, WV | 17 | moves into H5216-425 |
| Calhoun, WV | 14 | moves into H5216-425 |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
What else should you check?
- 2027 plans in Wood, WVThe plans you can join instead
- Humana plans for 2027Plans the same company still offers
- Every plan not offered in 2027764 Medicare Advantage and drug plans