HUMANA PPO — DALLAS COUNTY

2027 Plan Changes | Assistant Calling Instructions

🚨 PRIORITY — CLIENTS MUST BE CONTACTED

Humana is discontinuing the current Value Choice PPO (H7617-043) in Dallas County for 2027.

The good news is that Humana still offers another PPO in Dallas County, and clients who are happy with Humana can enroll in that plan.

IMPORTANT: Clients must actively enroll in the new PPO. Their current plan will end December 31, 2026, and they will not automatically move into the new PPO.

If they do nothing, they could lose their Medicare Advantage coverage and associated benefits for January 1, 2027.

📞 CALLING INSTRUCTIONS

This should be a relatively short list, so every client needs to be accounted for.

Call clients multiple times daily until reached, within permitted calling hours.
Try different times: morning, lunch, and late afternoon.
Leave a voicemail and send an approved text when appropriate.
Document every attempt.
Keep following up until the client has been reached and their next steps are clear.

Do not remove clients from the list just because you left a voicemail.

If a client requests no further calls, honor their request and notify Kevin.

🗣️ WHAT TO TELL CLIENTS

“Hi, this is [Name] with North Texas Medicare Advisors.

We’re reaching out because Humana is discontinuing your current PPO plan in Dallas County for next year.

The good news is they still have another PPO available that’s fairly similar to your current plan.

However, you’ll need to enroll in the new plan if you want to continue with Humana.

We want to make sure you’re taken care of before the December 7 deadline.”

Ask: “Have you been happy with your Humana plan, or would you like to look at other options?”

📋 2026 VS. 2027 PLAN COMPARISON

2026: Humana Value Choice H7617-043 PPO

2027: Humana Value Choice H7617-120 PPO

[Comparison Below]

✅ IF THE CLIENT WANTS TO STAY WITH HUMANA

Explain that they have two options:

OPTION 1 — CALL HUMANA DIRECTLY (FASTEST)

Humana has a dedicated enrollment line for affected clients.

866-753-4920

7:00 AM – 7:00 PM Central Time

Clients can call Humana directly to enroll in the new PPO without waiting for an appointment with our office.

This is the preferred option for clients who are happy with their current Humana PPO and simply want to continue with the new plan.

Remind them to confirm their doctors and medications before enrolling.

OPTION 2 — SCHEDULE WITH OUR OFFICE

Clients are welcome to meet with one of our agents.

However, appointments are currently approximately two weeks out.

If they already know they want the new Humana PPO, explain that calling Humana directly may save them time.

🔄 IF THE CLIENT WANTS ANOTHER PLAN

If they are unhappy with Humana or want to explore other coverage:

Schedule an appointment with your licensed agent.

Do not attempt to compare or recommend other plans yourself.

📝 AFTER EACH CALL

Update the client’s status:

No Answer: Continue follow-up.
Calling Humana: Client was given the dedicated enrollment number; follow up for confirmation.
Enrollment Completed: Client confirms enrollment; document the confirmation.
Appointment Scheduled: Client wants agent assistance.
Call Back: Record when to call.
Declined / Do Not Contact: Document and notify Kevin as appropriate.

Do not mark enrollment as complete simply because the client says they plan to call Humana.

⏰ DEADLINE: DECEMBER 7, 2026

The new coverage begins January 1, 2027.

Our goal is simple:

Contact every client, explain what’s happening, and make sure they understand how to avoid an interruption in their Medicare Advantage coverage.

No client should be overlooked.

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Humana Value Choice PPO — 2027 Review

2026 Plan: H7617-043

2027 Plan: H7617-120

Overall Picture

Humana is discontinuing your current PPO in Dallas County, but another Humana PPO will be available for 2027.

The new plan is similar, but there are some important changes to medical costs and dental benefits. You must enroll in the new plan to continue with this Humana PPO option.

What Stays the Same

Monthly premium: $0
Primary doctor: $0
Emergency room: $130
Urgent care: $50
Vision allowance: $200–$300
PPO flexibility remains available.

Medical Costs

Medical deductible: $0 → $250
Maximum out-of-pocket: $6,400 → $6,950
Specialist: $30 → $40
Hospital stay: $310 → $400 per day (days 1–6)
Outpatient surgery: $350 → $400
Surgery center: $275 → $325
MRI/CT scans: $200 → $205 (freestanding facility)
Outpatient diagnostic testing: $175 → $100 (improvement)

Dental Benefits

Annual allowance: $2,500 → $2,000
Many procedures previously covered at $0 will now require 30% coinsurance, including fillings, crowns and root canals.

Prescription Coverage

Drug deductible (Tiers 3–5): $420 → $520
Tiers 1 and 2 continue with a $0 deductible.

OTC Benefits

2026: $50 quarterly
2027: $60 quarterly
Unused funds can roll over between quarters but expire at year-end.

What Are Your Options?

If you’re happy with Humana, the new PPO may be a good option. You can enroll by calling Humana’s dedicated enrollment team: