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Humana Total Complete H0028-081 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Total Complete H0028-081 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Total Complete H0028-081 (HMO) in 2026, please refer to our full plan details page.
Humana Total Complete H0028-081 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Colorado. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Total Complete H0028-081 (HMO) 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 Total Complete H0028-081 (HMO).
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 Total Complete H0028-081 (HMO), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4650.00 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
Humana Total Complete H0028-081 (HMO) features an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you pay an $8 copay for Tier 1 preferred generic drugs at standard pharmacies and preferred mail-order, while Tier 2 standard generic drugs carry a $47 copay. Tier 3 preferred brand drugs require a 48% coinsurance, and Tier 4 non-preferred drugs carry a 33% coinsurance. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Individuals who qualify for full Extra Help or the Low-Income Subsidy will also benefit from a reduced $0 Part D premium.
Additional Benefits
The Humana Total Complete H0028-081 (HMO) plan provides robust medical coverage with no copay for primary care visits, preventive services, and routine vision and hearing exams. For specialized care, members pay a $25 specialist copay, while inpatient hospital stays require a $325 daily copay for the first six days and no copay for days seven through ninety. Emergency medical care is covered with a $115 copay, which is waived if you are admitted, and urgent care visits require a $50 copay. Additional benefits include dental coverage up to a $2,500 annual limit with no copay for most preventive and comprehensive services. Home health care features no copay, while skilled nursing facilities require a $218 daily copay only after the first 20 days of care. Durable medical equipment and medical supplies are covered with coinsurance ranging from 10% to 20% and no copay.
Inpatient Hospital See details
Humana Total Complete H0028-081 (HMO) partially covers inpatient hospital benefits, featuring a $325 daily copay for days 1 to 6 and no copay for days 7 to 90, with no coinsurance. Unlimited additional acute care days are covered with no copay or coinsurance, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Total Complete H0028-081 (HMO) covers outpatient services with no coinsurance and variable copayments depending on the service. Members will pay no copay for ambulatory surgical center and blood services, $25 to $35 for outpatient substance abuse sessions, and $0 to $325 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Humana Total Complete H0028-081 (HMO) with a $35 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Total Complete H0028-081 (HMO) partially covers ambulance and transportation services, with prior authorization required for all ambulance rides. Covered ground ambulance services require a $335 copay and no coinsurance, air ambulance services require a $630 copay and no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Humana Total Complete H0028-081 (HMO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Total Complete H0028-081 (HMO) covers primary care benefits with no coinsurance, offering no copay for primary care visits, a $25 specialist copay, and copays between $15 and $35 for therapy and mental health services. Chiropractic services are partially covered with a $15 copay and no coinsurance, as routine chiropractic care is not covered.
Preventive Services See details
Humana Total Complete H0028-081 (HMO) covers preventive services, including annual physical exams, kidney disease education, and screenings, with no copays or coinsurance. However, additional preventive services are only partially covered; memory fitness and smoking cessation counseling are covered with no copay, but sub-services such as health education, weight management, and alternative therapies are not covered.
Hearing Services See details
Humana Total Complete H0028-081 (HMO) covers routine hearing exams, fitting evaluations, and OTC hearing aids with no copay or coinsurance. Other hearing exams require a $25 copay, and prescription hearing aids are partially covered with a $499 to $799 copay for up to two devices per year, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Humana Total Complete H0028-081 (HMO) partially covers vision services with no coinsurance, featuring routine eye exams and eyewear up to $300 annually with no copay, though other eye exams may have a copay up to $25. Standalone eyeglass lenses, standalone eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Total Complete H0028-081 (HMO) up to a $2,500 annual limit, excluding fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics. Most covered preventive and comprehensive services have no copay and no coinsurance, while Medicare-covered dental requires a $25 copay with no coinsurance, and prosthodontics require a 30% coinsurance with no copay.
Home Infusion bundled Services See details
Humana Total Complete H0028-081 (HMO) covers home infusion bundled services, with prior authorization required. Covered Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Total Complete H0028-081 (HMO) covers dialysis services with a 20% coinsurance and no copay. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment benefits are covered by Humana Total Complete H0028-081 (HMO), including durable medical equipment with a 15% coinsurance and no copay. Prosthetics and medical supplies carry a 15% to 20% coinsurance, while diabetic supplies require a 10% to 20% coinsurance and no copay, and diabetic therapeutic shoes or inserts have a $10 copay. Prior authorization is required for these covered medical equipment services.
Diagnostic and Radiological Services See details
Humana Total Complete H0028-081 (HMO) covers diagnostic and radiological services with prior authorization, including lab and outpatient X-ray services with no copay or coinsurance. Other diagnostic tests require a copay up to $50, diagnostic radiology ranges up to a $300 copay, and therapeutic radiology requires a $30 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered under the Humana Total Complete H0028-081 (HMO) plan with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Humana Total Complete H0028-081 (HMO) plan, as all associated sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Humana Total Complete H0028-081 (HMO) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 20, followed by a $218 daily copay and no coinsurance for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Total Complete H0028-081 (HMO) partially covers Other Services, offering acupuncture for a $25 copay and no coinsurance, alongside meal benefits and over-the-counter items with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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