Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
HumanaChoice, 2027
H5216Contract425Plan
PPO · 55 counties in West Virginia
Run by Humana Insurance Company (contract H5216), sold as Humana, owned by Humana Inc.
HumanaChoice (H5216-425) costs $29 a month in 2027, up $14 from 2026, with an in-network out-of-pocket limit of $7,600 ($7,350 in 2026). It takes in the members of H5216-395.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $15 | $29 | ▲up $14 |
| In-network out-of-pocket limit | $7,350 | $7,600 | ▲up $250 |
| Drug deductible | $300 | $700 | ▲up $400 |
| Hospital stay, in network | $325 a day for days 1–7, then $0 a day for days 8–90 | $380 a day for days 1–7, then $0 a day for days 8–90 | ▲up $275for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Ground ambulance, in network | $335 copay | $325 copay | ▼down $10 |
| Eyewear, yearly limit | $350 a year | $100 a year | ▼down $250 |
| Counties served | 48 | 55 | ▲up 7 |
| Drug tier 3, preferred brand | $47 | 17% of the cost | changed |
| Drug tier 5, specialty tier | 29% of the cost | 25% of the cost | ▼down 4 points |
| 11 lines do not 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 | $115 copay | $115 copay | no change |
| Medical deductible, in network | none | none | 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 |
| 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 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?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $5 | $5 |
| Tier 3 | Preferred Brand | $47 | 17% of the cost |
| Tier 4 | Non-Preferred Drug | 50% of the cost | 50% of the cost |
| Tier 5 | Specialty Tier | 29% of the cost | 25% of the cost |
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, 42 plans open to everyone are sold for 2027, this one included. Against the others, 23 plans have a lower out-of-pocket limit, 18 a higher one. On the premium, 28 plans have a lower premium, 13 a higher one.
Out-of-pocket limits of the 42 plans open to everyone
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 55 counties: $29 a month and $7,600.
West Virginia
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Which 2026 plans move into it, and what changes for their members?
For 2027 this plan takes in the members of 1 other plan, beside its own 6,257 members. In 2027 it costs $29 a month with a $7,600 limit; each row compares that with the plan its members had in 2026.
| 2026 plan | Members, Sept. 2026 | Members who move | Premium 2026 | Premium change | Limit 2026 | Limit change |
|---|---|---|---|---|---|---|
| HumanaChoiceH5216-395 | 917 | 774 | $17 | ▲up $12 | $6,550 | ▲up $1,050 |
Only the members of HumanaChoice (H5216-395) who live in the 14 counties where this plan is sold move into it (774 of its 917 members); in its other 2 counties the plan ends and members choose a new one. What happens where.
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.
Who runs this plan?
- Plan ID
- H5216-425
- Legal name of the contract
- Humana Insurance Company
- Sold as
- Humana
- Parent company
- Humana Inc.
- Plan type
- PPO
- 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
- 6,257
- 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 Berkeley, WVWhere 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.