A non-government entity
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 2026, 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 2026.
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 $2.00. 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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4900.00 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:
Sign up for Humana Gold Plus H0028-024 (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus H0028-024 (HMO) plan features an Enhanced Alternative drug benefit with a yearly prescription drug deductible of $615.00. After meeting the deductible, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies and through preferred mail order, or a $20.00 copay for standard mail order. Tier 2 standard generic drugs require a $47.00 copay at standard pharmacies as well as through preferred and standard mail services. For higher-tier medications, Tier 3 preferred brands require a 50% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy can reduce their Part D premium cost to $0.00.
Additional Benefits
The Humana Gold Plus H0028-024 (HMO) plan offers comprehensive coverage for essential medical needs, featuring no copay or coinsurance for primary care visits, routine physicals, and home health services. Specialist visits, physical therapy, and mental health services are highly accessible with a flat $25 copay and no coinsurance. For hospital care, inpatient stays require a $275 daily copay for the first six days followed by no copay, while outpatient hospital services range from no copay up to a $275 copay. This plan also includes valuable supplemental benefits, such as dental and vision care which offer select services and exams with no copay or coinsurance up to specified annual limits. Urgent care and emergency room visits are covered with copays of $50 and $130 respectively, with no coinsurance required. Specialized needs like durable medical equipment and dialysis require no copay but carry coinsurance rates of 15% and 20% respectively.
Inpatient Hospital See details
Humana Gold Plus H0028-024 (HMO) partially covers inpatient hospital services, requiring prior authorization and a $275 daily copay for days 1 through 6, followed by no copay for days 7 through 90 and no coinsurance. Sub-services such as non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H0028-024 (HMO) covers outpatient services with no coinsurance, featuring copays of $0 to $275 for outpatient hospital services and a $275 copay per stay for observation services. Outpatient substance abuse sessions have a $25 to $35 copay, while ambulatory surgical center and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Humana Gold Plus H0028-024 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Humana Gold Plus H0028-024 (HMO), with ground ambulance services requiring a $335 copay and air ambulance services requiring a $630 copay, both with no coinsurance. Transportation services to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H0028-024 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available for a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H0028-024 (HMO) provides primary care physician visits with no copay and no coinsurance, while specialist visits, therapy services, and psychiatric care require a $25 copay and no coinsurance. Podiatry and mental health services also carry a $25 copay, whereas chiropractic services are only partially covered because routine chiropractic care is not covered.
Preventive Services See details
Humana Gold Plus H0028-024 (HMO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered, offering memory fitness and chemotherapy wigs with no copay and no coinsurance, though sub-services like health education, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
Humana Gold Plus H0028-024 (HMO) covers hearing exams with a $25 copay for Medicare-covered services, no copay for routine annual exams, and no deductibles or coinsurance. Prescription hearing aids are partially covered with a $399 to $699 copay and no coinsurance—excluding inner ear, outer ear, and over-the-ear models—while over-the-counter hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Humana Gold Plus H0028-024 (HMO) partially covers vision services with no deductible, featuring an annual routine eye exam and eyewear like contact lenses or eyeglasses with no copay or coinsurance up to a $250 yearly limit. Other eye exams carry a copay of up to $25 with no coinsurance, while individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H0028-024 (HMO) offers partially covered dental services up to a $2,000 annual limit, excluding fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require a $25 copay and no coinsurance, covered prosthodontics have a 30% coinsurance and no copay, and all other covered preventive and comprehensive services require no copay and no coinsurance.
Home Infusion bundled Services See details
Humana Gold Plus H0028-024 (HMO) covers home infusion bundled services, which require prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H0028-024 (HMO) covers Dialysis Services with a 20% coinsurance and no copay, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus H0028-024 (HMO) covers durable medical equipment (DME) with a 15% coinsurance and no copay, and diabetic supplies with a 10% to 20% coinsurance and no copay. The plan also covers prosthetic devices at a 20% coinsurance, medical supplies at a 15% coinsurance, and diabetic therapeutic shoes or inserts with a $10 copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Humana Gold Plus H0028-024 (HMO) covers diagnostic and radiological services, offering no copay or coinsurance for lab and outpatient X-ray services. Diagnostic procedures and therapeutic radiological services require up to 20% coinsurance with copays up to $75, while diagnostic radiological services have a copay of up to $300 and no coinsurance.
Home Health Services See details
Humana Gold Plus H0028-024 (HMO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to access these covered services.
Cardiac Rehabilitation Services See details
Humana Gold Plus H0028-024 (HMO) does not cover Cardiac Rehabilitation Services, meaning there is no coverage, copay, or coinsurance for these therapies. This non-coverage applies to all related sub-services, including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H0028-024 (HMO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, requiring a daily copay of $10 for days 1 to 20 and $218 for days 21 to 100, with no coinsurance. Additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H0028-024 (HMO) covers acupuncture with a $25 copay and no coinsurance, as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved