A non-government entity
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H0028-080 (HMO D-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 SNP-DE H0028-080 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Omaha. 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 H0028-080 (HMO D-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 SNP-DE H0028-080 (HMO D-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.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus SNP-DE H0028-080 (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.
For Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $3.00. 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 $9250.00 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:
Sign up for Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) plan features an annual prescription drug deductible of $615. You can benefit from no copay on Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when using a standard pharmacy or preferred mail order. If you utilize standard mail order, Tier 1 drugs require a $10 copay for a one-month supply, while Tier 2 drugs require a $20 copay. For brand-name and specialty medications, the plan requires a 25% coinsurance. This 25% coinsurance rate applies to Tier 3 (Preferred Brand), Tier 4 (Non-Preferred Drug), and Tier 5 (Specialty Tier) prescriptions. This cost-sharing percentage remains the same whether you fill your prescriptions at a standard pharmacy or through mail order.
Additional Benefits
The Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) offers comprehensive medical coverage, featuring no copays and a 20% coinsurance for primary care, outpatient hospital services, and specialist visits. Inpatient hospital stays require a copay of $2,230 for acute care or $2,080 for psychiatric care, both with no coinsurance, while emergency room visits carry a $115 copay. Additionally, skilled nursing facility care is available with no coinsurance, requiring no copay for the first 20 days and a $218 daily copay for days 21 through 100. This plan also includes valuable supplemental benefits, such as dental coverage up to a $4,000 annual limit and hearing aid coverage up to $2,000 per ear yearly with no copays. Routine vision care offers a $550 annual allowance for eyewear with no copay and a 20% coinsurance, while transportation services cover up to 48 one-way trips per year with no copay or coinsurance. Furthermore, members can take advantage of home health services, over-the-counter items, and select preventive care with no copay or coinsurance.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required, and sub-services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered under the Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these benefits.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, providing up to 48 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services under the Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Primary care and specialist services under the Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) are covered with no copay and a 20% coinsurance, with prior authorization required for most services. While outpatient therapies, psychiatric care, and telehealth are covered, podiatry services, routine chiropractic care, and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, memory fitness, and select screenings. However, the benefit is only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access technologies, bathroom safety modifications, and counseling are not covered.
Hearing Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers routine hearing exams and fittings with no copay, though routine exams require a 20% coinsurance. Hearing aids are partially covered with no copay or coinsurance for up to $2,000 per ear annually, but prescription inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. The plan covers one routine eye exam and up to a $550 yearly limit for one pair of contact lenses or eyeglasses (lenses and frames), while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) dental benefits are partially covered up to a $4,000 annual maximum, featuring no copay and 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for most other services. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers home infusion bundled services with prior authorization, including Medicare Part B insulin which has a $35 copay and 0% to 20% coinsurance. Covered chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance, with no copay required for other Part B drugs.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers diagnostic and radiological services, all of which require prior authorization. Diagnostic tests, lab services, and outpatient X-rays are covered with a 20% coinsurance and no copay, while diagnostic radiological services require a 20% coinsurance and a $200 copay, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers some cardiac rehabilitation services with no copay and prior authorization, though certain specific services are not covered and require a 20% coinsurance. The non-covered services include standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) covers acupuncture with no copay and 20% coinsurance, alongside over-the-counter items and chronic illness meals with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and highly integrated services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved