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Humana Gold Plus Giveback H0028-066 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Giveback H0028-066 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus Giveback H0028-066 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus Giveback H0028-066 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Kansas City, MO-KS. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus Giveback H0028-066 (HMO-POS) 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 Giveback H0028-066 (HMO-POS).
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 Giveback H0028-066 (HMO-POS), 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 $55.00. 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 $250.00 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 $4150.00 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 Giveback H0028-066 (HMO-POS) plan has a $250 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions. For preferred generic drugs, you will pay a $5 copay at a standard or preferred mail pharmacy, and a $20 copay at a standard mail pharmacy. For standard generic drugs, you will pay a $47 copay. For preferred brand drugs, you will pay 46% coinsurance. For non-preferred drugs, you will pay 30% coinsurance. Once your total drug costs reach $2,000, you will enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan offers a variety of benefits with varying costs. You can expect no copay for many services, including primary care, preventive services, routine hearing exams, vision exams, and home health services. Other services like inpatient hospital stays, outpatient services, and emergency services have copays that vary in cost. This plan covers hearing aids, dental services, and medical equipment. The plan covers hearing exams and fittings for hearing aids with no copay, while prescription hearing aids have a copay between $499 and $799. Dental services have a $35 copay for Medicare dental services, and medical equipment is covered with 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For the first 6 days, there is a $395 copay, and for days 7-90, there is no copay. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $300, observation services with a $395 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual sessions with a copay between $35 and $40, and group sessions with a copay between $35 and $40. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus Giveback H0028-066 (HMO-POS) plan. Ground ambulance services have a $315 copay, while air ambulance services have a 20% 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 Giveback H0028-066 (HMO-POS) plan. Emergency Services have a $140 copay, Urgently Needed Services have a $65 copay, and Worldwide Emergency Services have a $140 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan covers primary care physician services and chiropractic services with no copay, while occupational therapy services, physician specialist services, mental health specialty services, psychiatric services, physical therapy, and speech-language pathology services have a $35 copay. Additional telehealth benefits have a copay between $0 and $65, and Opioid Treatment Program Services have a copay between $35 and $40. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and also covers additional services. The plan covers fitness benefits, kidney disease education services, and other preventive services, with no copay for glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan covers hearing exams with a $35 copay and routine hearing exams with no copay; fitting/evaluation for hearing aids have no copay, while prescription hearing aids have a copay between $499 and $799, and OTC hearing aids are covered up to $50 every three months. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan covers vision services, including routine eye exams with a copay of $0-$35, and eyewear with a $0 copay and a combined maximum benefit of $150 per year. Contact lenses and eyeglasses (lenses and frames) are covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $35 copay, and other dental services with a $2,000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services have no copay. Fluoride treatment and orthodontics are not covered. Prosthodontics (removable and fixed) have a 30% coinsurance and no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus Giveback H0028-066 (HMO-POS) plan. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Equipment is covered, and Diabetic Supplies have a 10-20% coinsurance with no copay, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $65, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $395, Therapeutic Radiological Services with a copay up to $30 and 20% coinsurance, and Outpatient X-Ray Services with no copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Humana Gold Plus Giveback H0028-066 (HMO-POS) plan, but are not covered in practice. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Humana Gold Plus Giveback H0028-066 (HMO-POS) plan with prior authorization required. There is no copay for days 1-20, and a $203 copay for days 21-100, with no coinsurance. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan covers acupuncture with a $35 copay, and a meal benefit with no copay. Over-the-counter items are also covered, with a maximum benefit of $50 every three months. Other services such as Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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