Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
PPO
HumanaChoice Giveback H5216-371 (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Arizona and offered by the health insurance company Humana. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Monthly Premium
$0
Annual Deductible
$400 annual deductible
Max Out-of-Pocket
$6,100
Primary doctor visit
$0 copay
Specialist visit
$35 copay
ER visit
$130 copay
Ambulance
$320 copay
HumanaChoice Giveback H5216-371 (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $400 annual deductible and a maximum out of pocket cost sharing of $9,750 In and Out-of-network
$6,100 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for HumanaChoice Giveback H5216-371 (PPO) are defined below.
Additional Benefits and Coverage
Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing
HumanaChoice Giveback H5216-371 (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. HumanaChoice Giveback H5216-371 (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. HumanaChoice Giveback H5216-371 (PPO) includes coverage for the following additional benefits:
Other benefits
Fitness benefit
Limited coverage
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage
Comparing the Quality Score of HumanaChoice Giveback (PPO) to Other Plans in Arizona
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2026, HumanaChoice Giveback (PPO) received an overall government quality rating of 3.5 stars out of 5 stars.
HumanaChoice Giveback (PPO) performed worse than Arizona’s State average overall quality score of 3.7 stars.
This Plan’s 5-star Gov’t Quality Score
Arizona State Average Score
Overall Government 5 Star Quality Rating
3.5
3.7
Summary rating of health plan quality
3.5
3.6
Staying healthy: screenings, tests, & vaccines
4
3.5
Managing chronic (long term) conditions
3
3.7
Member experience with health plan
4
3.1
Member complaints & changes in the health plan's performance
4
3.5
Health plan customer service
4
4.2
Summary rating of drug plan quality
3
3.5
Drug plan customer service
5
5.0
Member complaints & changes in the drug plan's performance
3
3.2
Member experience with the drug plan
3
3.2
Drug safety & accuracy of drug pricing
3
3.8
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
HumanaChoice Giveback (PPO) received 3.5 stars for its health plan quality score which is worse than the Arizona State average health plan quality score of 3.6 stars.
HumanaChoice Giveback (PPO) received 3 stars for its drug plan quality score which is worse than the Arizona State average drug plan quality score of 3.5 stars.
In-network:
Tier 1
$375 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Out-of-network:
$495 per day for days 1-20
$0 per day for days 21-90
$0 per stay
In-network:
Tier 1
$10 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
$10 per day for days 1-20
$218 per day for days 21-100
$0 per stay
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $320 copay
Out-of-network: $320 copay
Therapy services
Occupational therapy visit
In-network: $30 copay
Out-of-network: $40 copay
Physical therapy & speech & language therapy visit
In-network: $30 copay
Out-of-network: $40 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $25 copay
Out-of-network: $25 copay
Outpatient individual therapy with a psychiatrist
In-network: $25 copay
Out-of-network: $25 copay
Outpatient group therapy visit
In-network: $25 copay
Out-of-network: $25 copay
Outpatient individual therapy visit
In-network: $25 copay
Out-of-network: $25 copay
Opioid treatment services
Opioid treatment services
Covered
Other services
Durable medical equipment (like wheelchairs & oxygen)
In this article we rank Arizona Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.
The Medicare landscape in Arizona is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Arizona.
Health Plan Radar