HumanaChoice H5216-425 (PPO) in Calhoun County, West Virginia — 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 H5216-425 (PPO) (H5216-425) is a $15-premium Medicare Advantage PPO from Humana Inc. available in Calhoun County, West Virginia in 2026, with a 3.5-star overall rating, a $7,350 in-network out-of-pocket maximum, and a $300 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationHumana Inc.
Plan nameHumanaChoice H5216-425 (PPO)
Contract IDH5216
Plan ID425
Segment ID0
Contract year2026
Contract categoryMA-PD
Plan typePPO
SNPNo
Monthly consolidated premium$15.00
Part C premium$15.00
Part D basic premium$0.00
Part D total premium$0.00
Annual Part D deductible$300.00
Maximum out-of-pocket (in-network)$7350.00
Overall star rating3.5

How this plan is structured

How it compares in Calhoun County

The CMS CY2026 Landscape file lists 46 Medicare Advantage plans in Calhoun County, West Virginia, of which 0 carry a 5.0-star overall rating and 25 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $154.00 per month, and in-network out-of-pocket maximums range from $4000.00 to $9250.00.

For the full county plan directory, see all Medicare plans in Calhoun County, West Virginia.

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:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5216-425.
  2. 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.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H5216-425 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5216-425, 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 425 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 H5216-425 (PPO) an HMO or PPO?

HumanaChoice H5216-425 (PPO) is a PPO Medicare Advantage plan.

Does HumanaChoice H5216-425 (PPO) include prescription drug coverage?

Yes — HumanaChoice H5216-425 (PPO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $300.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for HumanaChoice H5216-425 (PPO)?

The 2026 in-network maximum out-of-pocket limit for HumanaChoice H5216-425 (PPO) is $7350.00, per the CMS CY2026 Landscape file.

What counties offer HumanaChoice H5216-425 (PPO) (H5216-425)?

HumanaChoice H5216-425 (PPO) (H5216-425) is offered in 48 West Virginia counties: Barbour County, Berkeley County, Boone County, Braxton County, Brooke County, Cabell County, Calhoun County, Clay County, Doddridge County, Fayette County, Gilmer County, Greenbrier County, Hancock County, Hardy County, Harrison County, Jackson County, Jefferson County, Kanawha County, Lewis County, Lincoln County, Logan County, Marion County, Marshall County, Mason County, McDowell County, Mercer County, Mingo County, Monongalia County, Monroe County, Morgan County, Nicholas County, Ohio County, Pleasants County, Preston County, Putnam County, Raleigh County, Randolph County, Ritchie County, Summers County, Taylor County, Tucker County, Tyler County, Wayne County, Webster County, Wetzel County, Wirt County, Wood County, and Wyoming County.

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