HumanaChoice H5216-001 (PPO) in Sheboygan County, Wisconsin — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
HumanaChoice H5216-001 (PPO) (H5216-001) is a $81-premium Medicare Advantage PPO from Humana Inc. available in Sheboygan County, Wisconsin in 2026, with a 3.5-star overall rating, a $4,200 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Humana Inc. |
|---|---|
| Plan name | HumanaChoice H5216-001 (PPO) |
| Contract ID | H5216 |
| Plan ID | 001 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | PPO |
| SNP | No |
| Monthly consolidated premium | $81.00 |
| Part C premium | $7.50 |
| Part D basic premium | $73.50 |
| Part D total premium | $73.50 |
| Annual Part D deductible | $615.00 |
| Maximum out-of-pocket (in-network) | $4200.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $81 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PPO plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $4,200 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Sheboygan County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Sheboygan County
The CMS CY2026 Landscape file lists 52 Medicare Advantage plans in Sheboygan County, Wisconsin, of which 0 carry a 5.0-star overall rating and 28 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $226.00 per month, and in-network out-of-pocket maximums range from $3400.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Sheboygan County, Wisconsin.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5216-001.
- Call the plan (Humana Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H5216-001 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5216-001, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5216 are the contract number issued to the organization, and the three-digit 001 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is HumanaChoice H5216-001 (PPO) an HMO or PPO?
HumanaChoice H5216-001 (PPO) is a PPO Medicare Advantage plan.
Does HumanaChoice H5216-001 (PPO) include prescription drug coverage?
Yes — HumanaChoice H5216-001 (PPO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for HumanaChoice H5216-001 (PPO)?
The 2026 in-network maximum out-of-pocket limit for HumanaChoice H5216-001 (PPO) is $4200.00, per the CMS CY2026 Landscape file.
What counties offer HumanaChoice H5216-001 (PPO) (H5216-001)?
HumanaChoice H5216-001 (PPO) (H5216-001) is offered in 26 Wisconsin counties: Brown County, Calumet County, Dodge County, Door County, Fond du Lac County, Forest County, Green Lake County, Kenosha County, Kewaunee County, Manitowoc County, Marathon County, Marinette County, Marquette County, Menominee County, Milwaukee County, Oconto County, Outagamie County, Ozaukee County, Portage County, Racine County, Sheboygan County, Washington County, Waukesha County, Waupaca County, Waushara County, and Winnebago County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.