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Humana Gold Plus - Diabetes and Heart (HMO C-SNP)

Health Insurance Company: Humana

Medicare Advantage Plan Details

Chronic Condition (C-SNP)

Humana
$0 /mo
monthly premium
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
Additional Coverage
Overall Star Rating (2025)
  • Rx
  • Dental
  • Vision
  • Hearing
3.5
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$9350
Rx Drug Coverage
Yes
Rx Deductible
$590
Primary Doctor Office Visit
20% coinsurance per visit
Specialist Office Visit
20% coinsurance 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
20% coinsurance per visit
Specialist Office Visit
20% coinsurance per visit
Periodic Exam Coverage
$0 copay

Emergency Room

$110 copay per visit (always covered)

Ambulance Coverage

$315 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: $0 copay or 20% coinsurance
Medicare-covered lab services: $0-30 copay or 20% coinsurance
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): $200-300 copay or 20% coinsurance
Medicare-covered x-ray services: 20% coinsurance

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: 20% coinsurance per visit

Hospitalization Coverage

Inpatient hospital-acute:
$2,050 per stay
Inpatient hospital psychiatric:
$1,980 per stay

Rehabilitation Coverage

Occupational therapy services:
20% coinsurance
Physical therapy and speech and language therapy services:
20% coinsurance

Urgent Care Coverage

20% coinsurance per visit (always covered)

Skilled Nursing Facility (SNF)

$0 per day for days 1 through 20
$214 per day for days 21 through 100

Mental Health Coverage

Medicare-covered individual sessions: 20% coinsurance
Medicare-covered group sessions: 20% coinsurance

Dental, Vision, Hearing Benefits

Dental Services

Oral exams:
In-network: $0 copay
Out-of-network: $0 copay
Prophylaxis (cleaning):
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays:
In-network: $0 copay
Out-of-network: $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: 20% coinsurance
Hearing aids:
Hearing aids (all types): $0 copay

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$5.00 copay (30-day supply)
$15.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

$100.00 copay (30-day supply)
$300.00 copay (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Tier 1: Preferred Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 2: Generic

$20.00 copay (30-day supply)
$60.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

$100.00 copay (30-day supply)
$300.00 copay (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$5.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$131.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

$100.00 copay (30-day supply)
$290.00 copay (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

More Additional Benefits

Annual physical exams
Yes
Chiropractic Coverage
No
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

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Additional Plan Info

Plan Year:
2025
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
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint