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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 2026, 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 2026.
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 $58.00. 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 $4200.00 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) prescription drug plan features an annual drug deductible of $615. During the initial coverage phase, Tier 1 preferred generic drugs are available with no copay at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost as little as a $5 copay for a one-month supply, with no copay required for a three-month supply when filled through preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply, with discounted three-month supplies available through preferred mail order for $131. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance. This plan offers a clear cost structure to help you manage your monthly prescription medication expenses.
Additional Benefits
The Humana Gold Plus Giveback H0028-066 (HMO-POS) plan offers robust coverage for daily healthcare needs, frequently featuring no coinsurance for key services. Members enjoy no copay for primary care doctor visits, annual physicals, routine eye exams, and home health care. Specialist visits, physical therapy, and mental health services require a $30 copay, while inpatient hospital stays carry a $375 daily copay for the first seven days. In addition to medical care, this plan provides up to $3,000 in dental benefits with no copay for most preventive and comprehensive services. Routine hearing exams and over-the-counter hearing aids also feature no copay, though prescription hearing aids require a copay between $699 and $999. Diagnostic lab services and outpatient x-rays are covered with no copay, whereas durable medical equipment and dialysis services carry a 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits under the Humana Gold Plus Giveback H0028-066 (HMO-POS) are partially covered with no coinsurance, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute stays require a $375 daily copay for days 1 to 7 and no copay for days 8 and beyond, while covered psychiatric stays require a $334 daily copay for days 1 to 7 and no copay for days 8 to 90.
Outpatient Services See details
Outpatient services under Humana Gold Plus Giveback H0028-066 (HMO-POS) are covered with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay between $0 and $300, observation services have a $375 copay per stay, and outpatient substance abuse sessions range from a $30 to $35 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus Giveback H0028-066 (HMO-POS) with a $35.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus Giveback H0028-066 (HMO-POS), requiring a $335 copay for ground ambulance services and a 20% coinsurance for air ambulance services. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $65 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) features primary care physician visits with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and mental health services require a $30 copay and no coinsurance. Podiatry and chiropractic services are not covered by the plan, and telehealth benefits are offered with a $0 to $65 copay and no coinsurance.
Preventive Services See details
Preventive services are covered by Humana Gold Plus Giveback H0028-066 (HMO-POS) with no copays and no coinsurance for annual physical exams, kidney disease education, and screenings like glaucoma and diabetes self-management. Additional preventive benefits are only partially covered, offering a memory fitness benefit with no copay but excluding services such as health education, in-home safety assessments, and nutritional therapy.
Hearing Services See details
Hearing services are partially covered by the Humana Gold Plus Giveback H0028-066 (HMO-POS) plan, as prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. Routine hearing exams, fitting evaluations, and OTC hearing aids have no copay and no coinsurance, while Medicare-covered exams require a $30 copay and no coinsurance, and covered prescription hearing aids carry a $699 to $999 copay with no coinsurance.
Vision Services See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) covers vision services with no coinsurance, featuring no copay for one routine eye exam and one pair of eyeglasses or contact lenses per year up to a $100 limit. Other eye exams may require a copay of up to $30, while separate eyeglass lenses, separate frames, upgrades, and other eye exam services are not covered.
Dental Services See details
Dental Services are partially covered by Humana Gold Plus Giveback H0028-066 (HMO-POS), providing up to $3,000 in annual benefits with no copay and no coinsurance for most preventive and comprehensive services, though prosthodontics require a 30% coinsurance and no copay, and Medicare-covered dental has a $30 copay and no coinsurance. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus Giveback H0028-066 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay. Medical supplies are covered with a 15% coinsurance and no copay, while diabetic supplies carry a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus Giveback H0028-066 (HMO-POS) with no coinsurance, requiring prior authorization for all services. Lab services and outpatient x-rays feature no copay, while diagnostic procedures range from a $0 to $65 copay, and therapeutic radiology services require a minimum copay of $20.
Home Health Services See details
Home health services are covered by Humana Gold Plus Giveback H0028-066 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) does not cover Cardiac Rehabilitation Services, as none of the individual sub-services are covered in practice.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Giveback H0028-066 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10.00 daily copay for days 1 through 20 and a $218.00 daily copay for days 21 through 100. Prior authorization is required, and while a three-day prior hospital stay is not necessary, additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by Humana Gold Plus Giveback H0028-066 (HMO-POS), offering acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year with prior authorization. Over-the-counter items and chronic illness meal benefits are covered with no copay and no coinsurance, though meals require prior authorization and some other services are not covered.
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