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Humana Gold Plus H0028-024 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H0028-024 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H0028-024 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H0028-024 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Mohave County. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H0028-024 (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus H0028-024 (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Humana Gold Plus H0028-024 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $5.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5100.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Humana Gold Plus H0028-024 (HMO) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $10 copay for a preferred generic drug at a standard pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Humana Gold Plus H0028-024 (HMO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. You can expect copays for services like emergency care, specialist visits, and some therapies, while many preventive, vision, and dental services have no copay. This plan also provides additional benefits such as hearing aids, and coverage for ambulance services, with specific copays for each. The plan also offers coverage for home health services, and medical equipment, with varying coinsurance amounts. Other services include acupuncture, OTC items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric services, with a copay of $289 for days 1-6 and no copay for days 7-90. Additional days for inpatient hospital-acute has no copay, but non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $289, and observation services with a $289 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have a $30 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H0028-024 (HMO) plan, with a $100 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H0028-024 (HMO) plan. Ground ambulance services have a copay of $315, and air ambulance services have a copay of $630; both have no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Humana Gold Plus H0028-024 (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services has a $45 copay.
Primary Care See details
The Humana Gold Plus H0028-024 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, mental health specialty services with a $30 copay for individual and group sessions, podiatry services with a $30 copay, other health care professional services with a copay between $0 and $30, psychiatric services with a $30 copay for individual and group sessions, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a copay between $0 and $45, and opioid treatment program services with a $30 copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, Annual Physical Exams with no copay, and Additional Preventive Services with a copay. This plan also covers Kidney Disease Education Services, and Other Preventive Services with no copay.
Hearing Services See details
Humana Gold Plus H0028-024 (HMO) covers hearing services, including hearing exams with a $30 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with prescription hearing aids (all types) having a copay between $299 and $599. OTC hearing aids are covered up to a maximum of $60 every three months.
Vision Services See details
The Humana Gold Plus H0028-024 (HMO) plan covers vision services including eye exams and eyewear. Eye exams have a copay between $0 and $30, while routine eye exams, contact lenses, and eyeglasses (lenses and frames) have no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H0028-024 (HMO) plan covers Medicare Dental Services with a $30 copay, and covers Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), and Other Preventive Dental Services with no copay. This plan also covers Restorative Services, Adjunctive General Services, Endodontics, Periodontics, and Oral and Maxillofacial Surgery with no copay, and Prosthodontics and fixed with a 30% coinsurance. However, Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Insulin and other Medicare Part B drugs, are covered with prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, and coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H0028-024 (HMO) plan and require prior authorization. The coinsurance for dialysis services is between 20% and 20%.
Medical Equipment See details
The Humana Gold Plus H0028-024 (HMO) plan covers Durable Medical Equipment with a 20% coinsurance and no copay, and covers Prosthetic Devices with a 20% coinsurance and no copay. Medical Supplies have a 20% coinsurance and no copay. Diabetic Supplies have a 10-20% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have no copay and a coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with coinsurance. Diagnostic Procedures/Tests have a copay of up to $75 and a coinsurance of at least 20%, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $300, while Therapeutic Radiological Services have a copay of up to $35 and at least 20% coinsurance, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H0028-024 (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the following sub-services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services require prior authorization and have a copay of $10 for days 1-20 and $214 for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services", acupuncture has a $30 copay per visit, and the plan covers up to 20 treatments per year. Over-the-counter (OTC) items are covered, with a maximum benefit of $60 every three months, and also includes nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay, and requires prior authorization.
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