Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)

Health Insurance Company: Humana

Medicare Advantage Plan Details

Medicare-Medicaid Dual Eligible (D-SNP)

Humana
$41 /mo
monthly premium
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
Additional Coverage
Overall Star Rating (2024)
  • Rx
  • Dental
  • Vision
  • Hearing
4
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$8850
Rx Drug Coverage
Yes
Rx Deductible
$545
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$0 or $45 copay per visit

Additional Benefits

Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Transportation for non-emergency
Yes
Fitness Benefits
Yes
Worldwide emergency
Yes
Telehealth
Yes
Part B Give Back
No

Doctor & Hospital Coverage

Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$0 or $45 copay per visit
Periodic Exam Coverage
$0 copay

Emergency Room

$0 or $100 copay per visit (always covered)

Ambulance Coverage

$0 or $200 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: $0 or $0-45 copay
Medicare-covered lab services: $0 or $0-45 copay
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): $0 or $150-200 copay or 20% coinsurance
Medicare-covered x-ray services: $0 or $0-125 copay

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: $0 or $45-200 copay or 20% coinsurance per visit

Hospitalization Coverage

Inpatient hospital-acute:
$0 or $650 per day for days 1 through 3
$0 per day for days 4 through 90
$0 per day for days 90 and beyond
Inpatient hospital psychiatric:
$0 or $615 per day for days 1 through 3
$0 per day for days 4 through 90

Rehabilitation Coverage

Occupational therapy services:
$0 or $20 copay
Physical therapy and speech and language therapy services:
$0 or $20 copay

Urgent Care Coverage

$0 or $45 copay per visit (always covered)

Skilled Nursing Facility (SNF)

$0 per day for days 1 through 20
$0 or $203 per day for days 21 through 100

Mental Health Coverage

Medicare-covered individual sessions: $0 or $45 copay
Medicare-covered group sessions: $0 or $45 copay

Dental, Vision, Hearing Benefits

Dental Services

Oral exams: $0 copay
Prophylaxis (cleaning): $0 copay
Dental x-rays: $0 copay

Vision Benefits

Eye exams:
Routine eye exams: $0 copay
Eyewear:
Contact Lenses: $0 copay
Eyeglasses: $0 copay

Hearing Benefits

Hearing exams:
Routine hearing exams: $0 or $0-45 copay
Hearing aids:
Hearing aids (all types): $0 copay

More Additional Benefits

Annual physical exams
Yes
Chiropractic Coverage
Yes
Acupuncture
Yes
Massage Therapy
No
Health Education
No
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
No
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
Yes

Plan Links

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Where This Plan is Available

Additional Plan Info

Plan Year:
2024
Insurance Company Website:
Humana

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Aspire Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Premera Blue Cross
  • Medica Central Health Plan
  • SCAN Health Plan
  • Baylor Scott & White Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint