Humana Gold Plus - Diabetes and Heart (HMO C-SNP)

Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Albuquerque. 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 C-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 - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-SNP) plan features an annual drug deductible of $140. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, you will pay no copay for one-month and three-month supplies at standard pharmacies and through preferred mail order. If you use standard mail order, Tier 6 drugs remain at no copay, while Tier 1 generics carry a $10 to $30 copay and Tier 2 generics carry a $20 to $60 copay. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both require a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order options. Specialty drugs in Tier 5 carry a 31% coinsurance for a one-month supply regardless of whether you use standard pharmacies, preferred mail order, or standard mail order.

Additional Benefits

The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) offers comprehensive medical coverage featuring no copay for primary care and specialist visits, though a 20% coinsurance applies. For hospital care, inpatient acute stays require a $2,230 copay per stay with no coinsurance, while emergency services have a $115 copay that is waived if you are admitted. Outpatient services, dialysis, and durable medical equipment are also covered with no copay and a 20% coinsurance. This plan also includes valuable supplemental benefits, such as dental coverage up to a $2,000 annual limit and eyewear up to a $250 annual limit with no copay. Additionally, members can access up to 40 routine one-way transportation trips and home health services with no copay and no coinsurance. Skilled nursing facility stays are covered with no copay for the first 20 days and a $218 daily copay for days 21 to 100, with no coinsurance.