Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP)

Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in San Antonio, Corpus Christi, RGV, El Paso Metro. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) 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 SNP-DE H0028-036 (HMO D-SNP).

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.

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:

Drug Coverage

The Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using standard pharmacies or preferred mail order services for both 1-month and 3-month supplies. If you choose standard mail order, Tier 1 drugs carry a $10 to $30 copay, while Tier 2 drugs require a $20 to $60 copay depending on the supply duration. For higher-tier medications, including Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a consistent 25% coinsurance. This 25% coinsurance applies across standard pharmacies, preferred mail order, and standard mail order options for Tier 3 and Tier 4 drugs. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply across all available pharmacy and mail order channels.

Additional Benefits

The Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) offers comprehensive medical coverage with no copay and a 20% coinsurance for primary care, specialist visits, and outpatient services. For hospital stays, members pay a $2,230 copay per stay for acute inpatient care and a $2,080 copay per stay for psychiatric care, both with no coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Many essential and preventive services feature no copay and no coinsurance, including routine annual physicals, home health services, and over-the-counter items. Additionally, the plan provides dental benefits with no copay and no coinsurance up to a $3,000 annual limit, alongside a $300 annual allowance for vision eyewear and up to 100 one-way transportation trips per year. Hearing aid fittings and devices are also covered with no copay and no coinsurance, while routine hearing exams require a 20% coinsurance.