Humana Dual Select H5619-093 (HMO D-SNP)
Available to residents of Talladega County, AL for 2026. Contract H5619, plan 093, segment 0.
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- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
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- Browse the Humana Dual Select H5619-093 (HMO D-SNP) formulary
Renewed for 2026. CMS carries this plan forward from 2025.
Plan details
| Monthly premium (Part C + D) | $4.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $4.00? |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| In-network out-of-pocket maximum | $9,250.00? |
| Drug deductible | $615.00Tier 1 and 2 exempt |
| Drug out-of-pocket threshold | $2,100.00 |
| Plan type | HMO D-SNP? |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H5619-093-0 |
| Offered by | Humana |
| Parent organization | Humana Inc. |
| Formulary drugs | 3,359 |
| Formulary exception tier | 4? |
| Pharmacy search | www.humana.com/pharmacy/ |
| Member services | (888)873-0686TTY 711 |
CMS star ratings
- Overall
- 3 out of 5 stars for Overall
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5619 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $50 copay(authorization required) |
| Other health care professional | $0–$50 copay(authorization required) |
| Additional telehealth services | $0–$50 copay |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | $0 copay |
| Kidney disease education | $0 copay |
| Glaucoma screening | $0 copay |
| Diabetes self-management training | $0 copay |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0–$50 copay(authorization required) |
| Lab services | $0–$40 copay(authorization required) |
| Diagnostic radiology (e.g. MRI, CT) | $0–$780 copay(authorization required) |
| Therapeutic radiology | $50 copay; 20% coinsurance(authorization required) |
| Outpatient x-rays | $0–$130 copay(authorization required) |
| Emergency and urgent care | |
| Emergency room | $115 copay |
| Urgent care | $40 copay |
| Worldwide emergency coverage | $115 copay |
| Worldwide urgent care | $115 copay |
| Worldwide emergency transportation | $115 copay |
| Hospital care | |
| Inpatient hospital stay | $650 per day for days 1–3; $0 per day for days 4–90; $0 per day for days 91–999 (additional days)(authorization required) |
| Outpatient hospital services | $0–$550 copay(authorization required) |
| Outpatient observation | $650 copay(authorization required) |
| Ambulatory surgical center | $0–$400 copay(authorization required) |
| Outpatient blood services | $0 copay(authorization required) |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per day for days 1–20; $218 per day for days 21–100(authorization required) |
| Home health care | $0 copay(authorization required) |
| Kidney dialysis | 20% coinsurance(authorization required) |
| Rehabilitation | |
| Occupational therapy | $20 copay(authorization required) |
| Physical therapy and speech-language therapy | $20 copay(authorization required) |
| Cardiac rehabilitation | $15 copay(authorization required) |
| Pulmonary rehabilitation | $15 copay(authorization required) |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $615 per day for days 1–3; $0 per day for days 4–90(authorization required) |
| Outpatient mental health, individual session | $35 copay(authorization required) |
| Outpatient mental health, group session | $35 copay(authorization required) |
| Psychiatrist, individual session | $35 copay(authorization required) |
| Psychiatrist, group session | $35 copay(authorization required) |
| Partial hospitalization | $35 copay(authorization required) |
| Intensive outpatient program | $35 copay(authorization required) |
| Outpatient substance use, individual session | $35 copay(authorization required) |
| Outpatient substance use, group session | $35 copay(authorization required) |
| Opioid treatment program | $35 copay(authorization required) |
| Ambulance and transportation | |
| Ground ambulance | $335 copay(authorization required) |
| Air ambulance | 20% coinsurance(authorization required) |
| Transportation to plan-approved locations | $0 copay(authorization required, limits apply) |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | $0 copay; 20% coinsurance(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) |
| Medical supplies | 20% coinsurance(authorization required) |
| Diabetes supplies | $0 copay; 20% coinsurance(authorization required) |
| Diabetic therapeutic shoes or inserts | $0 copay(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $15 copay(authorization required) |
| Routine chiropractic care | $15 copay(authorization required, limits apply) |
| Acupuncture | $50 copay(authorization required, limits apply) |
| Foot exams and treatment (Medicare-covered) | $40 copay(authorization required) |
| Routine foot care | $35 copay(authorization required, limits apply) |
| Dental? | |
| Medicare-covered dental services | $50 copay(authorization required) |
| Preventive dental plan limit | $1,000 plan limit every year |
| Oral exams | $0 copay |
| Cleanings | $0 copay |
| Fluoride treatment | Not covered |
| Dental x-rays | $0 copay |
| Other diagnostic dental services | $0 copay |
| Other preventive dental services | $0 copay |
| Restorative services (fillings, crowns) | $0 copay(authorization required) |
| Endodontics (root canals) | $0 copay(authorization required) |
| Periodontics (gum disease) | $0 copay(authorization required) |
| Dentures and other removable prosthodontics | $0 copay(authorization required) |
| Maxillofacial prosthetics | Not covered |
| Implants | Not covered |
| Bridges and other fixed prosthodontics | $0 copay(authorization required) |
| Oral and maxillofacial surgery | $0 copay(authorization required) |
| Orthodontics | Not covered |
| Adjunctive general services | $0 copay(authorization required) |
| Vision? | |
| Eye exam (Medicare-covered) | $0–$50 copay(authorization required) |
| Routine eye exam | $0 copay(authorization required, limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(authorization required, limits apply) |
| Eyewear plan limit | $250 plan limit every year |
| Contact lenses | $0 copay(authorization required, limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(authorization required, limits apply) |
| Eyeglass lenses | Not covered |
| Eyeglass frames | Not covered |
| Eyewear upgrades | Not covered |
| Hearing? | |
| Hearing exam (Medicare-covered) | $50 copay(authorization required) |
| Routine hearing exam | $0 copay(authorization required, limits apply) |
| Hearing aid fitting and evaluation | $0 copay(authorization required) |
| Hearing aids (all types) | $0 copay(limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Medicare Part B drugs | |
| Part B insulin | $0 copay; 0%–20% coinsurance(authorization required, step therapy may apply) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other Part B drugs | $0 copay; 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | Covered (allowance not stated) |
| Meals after a hospital stay or for a chronic condition | $0 copay(authorization required) |
| Fitness benefit | $0 copay(authorization required) |
| Health education | Not covered |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | $0 copay(authorization required) |
| Enhanced disease management | Not covered |
| Telemonitoring | Not covered |
| Remote access technologies (web/phone, nurse line) | Not covered |
| Home and bathroom safety devices | Not covered |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | Not covered |
| Wigs for hair loss from chemotherapy | $0 copay(authorization required) |
| Weight management programs | Not covered |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | $0 copay(authorization required) |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | 25% |
| Tier 4 | 25% |
| Tier 5 | 25% |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial deductible phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | 25% | 25% | 25% | 25% | 25% | 25% |
| Tier 4: Non-Preferred Drug | 25% | 25% | 25% | 25% | 25% | 25% |
| Tier 5: Specialty Tier | 25% | 25% | 25% | n/a | n/a | n/a |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 5: Specialty Tier | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Also available in 62 other AL counties
- Autauga
- Baldwin
- Barbour
- Bibb
- Blount
- Bullock
- Butler
- Calhoun
- Chambers
- Chilton
- Choctaw
- Clarke
- Clay
- Cleburne
- Coffee
- Colbert
- Conecuh
- Coosa
- Covington
- Crenshaw
- Cullman
- Dale
- Dallas
- Elmore
- Escambia
- Etowah
- Fayette
- Franklin
- Geneva
- Greene
- Hale
- Henry
- Houston
- Jefferson
- Lamar
- Lauderdale
- Lawrence
- Lee
- Limestone
- Lowndes
- Macon
- Madison
- Marengo
- Marion
- Marshall
- Mobile
- Monroe
- Montgomery
- Morgan
- Perry
- Pickens
- Pike
- Randolph
- Russell
- St. Clair
- Shelby
- Sumter
- Tallapoosa
- Walker
- Washington
Benefits in plain text
Humana Dual Select H5619-093 (HMO D-SNP) (H5619-093-0) is a 2026 HMO D-SNP Medicare Advantage plan offered by Humana, available to residents of Talladega County, AL.
The monthly premium is $4.00 (Part C and Part D together).
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
Its in-network out-of-pocket maximum is $9,250.00.
The drug deductible is $615.00. Tier 1 and 2 exempt.
It is a special needs plan (Dual-eligible SNP).
The plan's formulary lists 3,359 drugs.
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: $0.00; tier 2: $0.00; tier 3: 25%; tier 4: 25%; tier 5: 25%.
CMS gives the plan's contract (H5619) an overall rating of 3 out of 5 stars.
Email a copy of the plan benefit details
Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.