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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 $4825.00 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 Total Complete H0028-081 (HMO) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost $8 for a 1-month supply at standard pharmacies and preferred mail order, with no copay required for a 3-month supply filled through preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a 1-month supply at standard pharmacies and mail order services. Higher-tier medications are subject to coinsurance, with Tier 4 non-preferred drugs requiring a 48% coinsurance and Tier 5 specialty drugs requiring a 33% coinsurance.
Additional Benefits
The Humana Total Complete H0028-081 (HMO) plan offers affordable medical coverage with no copay and no coinsurance for primary care visits, preventive exams, and home health services. For inpatient hospital stays, members pay a $325 daily copay for days one through six and no copay for days seven through 90. Outpatient hospital services and emergency care are also covered with no coinsurance, featuring copays ranging from no copay up to $325 depending on the treatment. This plan also includes robust supplemental benefits, such as routine dental, vision, and hearing care with no copay and no coinsurance for standard services. Dental benefits cover up to $1,500 annually for most preventive and comprehensive care, while routine vision eyewear is covered up to a $350 annual limit. Additionally, members can take advantage of over-the-counter items and meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
Humana Total Complete H0028-081 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $325 copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Total Complete H0028-081 (HMO) covers outpatient services with no coinsurance, featuring a copay of $0 to $325 for outpatient hospital services and $325 per stay for observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions have a copay of $25 to $35.
Partial Hospitalization See details
Partial hospitalization services are covered under the Humana Total Complete H0028-081 (HMO) plan with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Total Complete H0028-081 (HMO) covers Medicare-covered ground ambulance services with a $335 copay and air ambulance services with a $630 copay, with no coinsurance and prior authorization required. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Humana Total Complete H0028-081 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are available with a $130 copay and no coinsurance.
Primary Care See details
Humana Total Complete H0028-081 (HMO) offers primary care physician services and select telehealth benefits with no copay and no coinsurance. Other covered benefits, including specialist visits, physical therapy, and mental health services, require no coinsurance but have copays ranging from $15 to $35, while chiropractic services are only partially covered since other chiropractic services are not covered.
Preventive Services See details
Humana Total Complete H0028-081 (HMO) offers preventive services with no copay and no coinsurance for covered benefits, including annual physical exams, kidney disease education, and a memory fitness benefit. While many screenings and exams are covered, these benefits are only partially covered as services such as health education, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
Humana Total Complete H0028-081 (HMO) covers hearing services with no deductible, offering routine exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Medicare-covered exams require a $30 copay and no coinsurance, while up to two prescription hearing aids per year are partially covered with a $399 to $999 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
Vision Services are partially covered by Humana Total Complete H0028-081 (HMO), offering routine eye exams and eyewear with no copay and no coinsurance, up to a $350 annual maximum. There is no deductible, but prior authorization is required, and other eye exam services, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Humana Total Complete H0028-081 (HMO) features partially covered dental services with up to $1,500 in annual benefits, offering no copay and no coinsurance for most preventive and comprehensive care, 30% coinsurance for prosthodontics, and a $30 copay with no coinsurance for Medicare-covered dental. Fluoride treatments, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Humana Total Complete H0028-081 (HMO) plan with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry coinsurance ranging from no coinsurance to 20%, while covered Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Total Complete H0028-081 (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Humana Total Complete H0028-081 (HMO) covers durable medical equipment (DME) with a 15% coinsurance and no copay. Prosthetic devices and medical supplies are covered with a 15% to 20% coinsurance and no copay, while diabetic supplies feature a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Total Complete H0028-081 (HMO) covers diagnostic and radiological services with prior authorization required. Members pay no copay and no coinsurance for lab services, a $0 to $50 copay with no coinsurance for diagnostic tests, no copay for diagnostic radiology and outpatient X-rays, and a $30 copay with 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Humana Total Complete H0028-081 (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Total Complete H0028-081 (HMO) with no copay and no coinsurance, although prior authorization is required. While some services are covered, specific sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Total Complete H0028-081 (HMO) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Total Complete H0028-081 (HMO) offers coverage for acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year, as well as over-the-counter items and meal benefits with no copay and no coinsurance. Other miscellaneous services and highly integrated dual eligible SNP benefits are not covered.
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