Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Cha HMO, Inc. available for the 2026 plan year to people living in Select Counties in Kansas. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Below are a few key facts and commonly-asked questions about Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.10. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
The Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) prescription drug plan has an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through preferred mail order. Tier 6 (Select Care Drugs) also features no copay across all standard pharmacy and mail order options. For mid-to-high tier medications, including Tier 3 (Preferred Brand), Tier 4 (Non-Preferred Drug), and Tier 5 (Specialty Tier) drugs, members are responsible for a 25% coinsurance. Standard mail order fills for Tier 1 drugs require a $10 copay for a one-month supply, while Tier 2 drugs require a $20 copay for a one-month supply. This plan offers a balanced mix of no-cost generics and percentage-based sharing for brand-name and specialty medications.
The Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) plan offers comprehensive coverage with predictable cost-sharing, featuring no copays for primary care, specialists, and outpatient services, though a twenty percent coinsurance typically applies. Inpatient acute stays require a copayment of $2,230 with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. Additionally, members can access twenty-four one-way transportation trips per year with no copay or coinsurance, alongside ground ambulance services for a $335 copay. Preventive care, home health visits, and select dental services up to a $4,000 annual limit are covered with no copays or coinsurance. For other essential needs, the plan features no copays and a twenty percent coinsurance on diagnostic tests, medical equipment, and routine vision or hearing exams. Prescription hearing aids are covered with copayments ranging from $699 to $999, while over-the-counter hearing aids, over-the-counter items, and chronic illness meals require no copay or coinsurance.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a copayment of $2,230 per acute stay and $2,080 per psychiatric stay. Prior authorization is required, and while unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) offers outpatient services with no copay, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay and no coinsurance, and prior authorization is required for most of these outpatient services.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for these services.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. The plan also partially covers transportation services, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require no copay and a 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent care, and emergency transportation services are covered with a $115 copay and no coinsurance.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) offers partially covered primary care benefits with no copay and a 20% coinsurance for most services, including PCP, specialist, mental health, and physical therapy visits. Chiropractic and podiatry services are not covered under this plan.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers preventive services, including annual physical exams, kidney disease education, and in-home support services, with no copay and no coinsurance. This benefit is partially covered, as many additional supplemental services, such as fitness benefits, health education, weight management programs, and remote access technologies, are not covered.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers hearing services with no deductible, including routine exams for a 20% coinsurance and no copay, and unlimited fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with a $699 to $999 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 or coinsurance.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) partially covers vision services, featuring no copays and 20% coinsurance for routine exams and eyewear, with no deductible and prior authorization required. While up to $200 annually is covered for one pair of contact lenses or eyeglasses (lenses and frames), other eye exams, separate lenses, separate frames, and upgrades are not covered.
Dental services are partially covered by Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP), offering Medicare-covered dental care with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $4,000 annual limit. While preventive and restorative care are included, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home infusion bundled services are covered by Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) with prior authorization and step therapy requirements. Covered Part B insulin has a $35 copay and 0% to 20% coinsurance, while other Part B drugs, including chemotherapy, carry a 0% to 20% coinsurance and no copay for standard Part B drugs.
Dialysis services are covered under the Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these covered items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and radiological services are covered by Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) subject to prior authorization and a 20% coinsurance. Diagnostic tests, lab services, diagnostic radiology, and outpatient X-rays have no copay, while therapeutic radiological services require a 20% coinsurance and a copayment.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to access these covered services.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) technically covers Cardiac Rehabilitation Services with no copay, but in practice, the benefit is not covered because standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require a 20% coinsurance.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. Patients pay no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Humana Gold Plus - Diabetes and Heart (HMO-POS C-SNP) partially covers other services, offering acupuncture with no copay and 20% coinsurance, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Other unspecified services and dual-eligible SNP services are not covered.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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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.
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