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Humana Gold Plus H0028-029 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H0028-029 (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 H0028-029 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H0028-029 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Corpus Christi Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H0028-029 (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 H0028-029 (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 H0028-029 (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 $3400.00 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 H0028-029 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay for one-month and three-month supplies filled at standard pharmacies or through preferred mail order. However, standard mail order delivery for these generic tiers requires a copay ranging from $10 to $60 depending on the tier and supply length. Tier 3 preferred brand drugs require a copay starting at $45 for a one-month supply, with preferred mail order offering the lowest cost for three-month supplies at $90. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance for a one-month supply across all pharmacy options. These structured tiers and copayments allow you to easily estimate your prescription drug costs under this Medicare Advantage plan.
Additional Benefits
Humana Gold Plus H0028-029 (HMO) provides comprehensive coverage for essential medical care with no copay for primary care visits, preventive services, and home health care. Specialist visits require a low $15 copay, while inpatient hospital stays cost a $75 daily copay for the first five days and no copay for subsequent days. Outpatient services, emergency care, and ambulance rides are also covered, though they require copays ranging up to $335 depending on the service. This plan features robust dental, vision, and hearing benefits, including no copay for routine hearing exams and up to a $2,000 annual limit for dental care with no copay for routine services. Vision coverage includes an annual routine eye exam and up to $300 for select eyewear with no copay or deductible. For specialized medical needs, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H0028-029 (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $75 daily copay for days 1 to 5 and no copay for days 6 to 90. Unlimited additional acute days are covered with no copay, but psychiatric additional days, room upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H0028-029 (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Medicare-covered outpatient hospital services have a copay of $0 to $125, observation services require a $75 copay per stay, and individual or group substance abuse sessions have a copay of $20 to $35.
Partial Hospitalization See details
Humana Gold Plus H0028-029 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H0028-029 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation services are partially covered, providing up to 60 one-way trips per year to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Humana Gold Plus H0028-029 (HMO) with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H0028-029 (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $15 copay and no coinsurance. Covered therapies and mental health services have copays ranging from $20 to $40 with no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H0028-029 (HMO) covers key preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive benefits are only partially covered, featuring a memory fitness program with no copay and no coinsurance, while excluding services such as health education, nutritional therapy, and in-home safety assessments.
Hearing Services See details
Humana Gold Plus H0028-029 (HMO) hearing services feature no deductible, with a $15 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams, fittings, and OTC hearing aids. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $499 to $799, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H0028-029 (HMO) partially covers vision services with no copay, no coinsurance, and no deductible, though prior authorization and referrals are required. Covered benefits include one routine eye exam annually and select eyewear up to a $300 yearly limit, while other eye exams, individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H0028-029 (HMO) partially covers dental services up to a $2,000 annual limit, with a $15 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered dental services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H0028-029 (HMO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin drugs are covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H0028-029 (HMO) covers dialysis services with no copay and a 20% coinsurance. Both prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H0028-029 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus H0028-029 (HMO), with prior authorization and referrals required. Outpatient diagnostic procedures and tests have a copay ranging from $0 to $65 with no coinsurance, while lab services and outpatient X-rays feature no copay. Diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services require a minimum $15 copay and a minimum 20% coinsurance.
Home Health Services See details
Humana Gold Plus H0028-029 (HMO) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to utilize this benefit.
Cardiac Rehabilitation Services See details
Humana Gold Plus H0028-029 (HMO) provides Cardiac Rehabilitation Services where some services are covered with no copay and no coinsurance, but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered. Prior authorization and referrals are required for this benefit.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H0028-029 (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit is partially covered as additional days beyond the standard Medicare-covered limit are not covered, and both prior authorization and referrals are required.
Other Services See details
Other services are partially covered by Humana Gold Plus H0028-029 (HMO), featuring acupuncture with a $15 copay and no coinsurance, and over-the-counter items and chronic illness meals with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, while dual eligible SNP services are not covered.
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