A non-government entity
Humana Gold Plus H0028-082 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H0028-082 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H0028-082 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H0028-082 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Honolulu, Kauai, Maui. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H0028-082 (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 Gold Plus H0028-082 (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 Gold Plus H0028-082 (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. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $5900.00 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 H0028-082 (HMO)
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 H0028-082 (HMO) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, beneficiaries enjoy no copay for 1-month and 3-month supplies at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also highly affordable, costing a $5 copay for a 1-month supply at standard pharmacies and preferred mail order, or no copay for a 3-month supply through preferred mail order. For brand-name and higher-tier medications, costs are structured around copays and coinsurance. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, which can be extended to a 3-month supply for a reduced $94 copay via preferred mail order. Tier 4 non-preferred drugs carry a 30% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply across all available pharmacy and mail order services.
Additional Benefits
The Humana Gold Plus H0028-082 (HMO) plan offers comprehensive coverage for essential medical needs with no coinsurance for many primary services, including inpatient hospital stays, outpatient care, and emergency visits. Under this plan, you will enjoy no copay for primary care physician visits, routine preventive services, and home health care. For other medical needs, you can expect fixed copays, such as $35 for specialist visits and $130 for emergency services, which is waived if you are admitted. This plan also features valuable supplemental benefits, including no copay for routine annual eye and hearing exams, plus up to $300 for eyewear and affordable copays for prescription hearing aids. Dental care is covered up to a $1,750 annual maximum with no copay for most preventive, diagnostic, and comprehensive services. Additionally, diagnostic lab tests and outpatient X-rays require no copay, while durable medical equipment and dialysis services carry a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H0028-082 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1 to 5 and no copay for days 6 to 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H0028-082 (HMO) outpatient services are covered with no coinsurance, though prior authorization and referrals are required. Under this plan, there is no copay for ambulatory surgical center or blood services, a $0 to $350 copay for outpatient hospital services, a $425 copay per stay for observation services, and a $25 to $35 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H0028-082 (HMO) with a $35 copay and no coinsurance. Prior authorization and a referral are required to access these services.
Ambulance and Transportation Services See details
Humana Gold Plus H0028-082 (HMO) covers ambulance services with prior authorization, requiring a $335 copay for ground services and a $1,250 copay for air services, with no coinsurance. Transportation services to plan-approved or health-related locations are not covered under the plan.
Emergency Services See details
Humana Gold Plus H0028-082 (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay 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 $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H0028-082 (HMO) provides primary care physician visits with no copay and no coinsurance, while specialists, therapy services, and routine podiatry require a $35 copay and no coinsurance. Mental health, psychiatric, and opioid treatments carry copays of $25 to $35 with no coinsurance, telehealth ranges from no copay to a $50 copay with no coinsurance, and some chiropractic services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus H0028-082 (HMO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and memory fitness benefits. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and home-based palliative care.
Hearing Services See details
Humana Gold Plus H0028-082 (HMO) offers hearing services with no coinsurance, featuring a $35 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with a copay ranging from $299 to $899 and no coinsurance for up to two aids per year, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H0028-082 (HMO) provides vision services with no deductible, featuring one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Covered eyewear, including one annual pair of contact lenses or eyeglasses (lenses and frames), has no copay and no coinsurance up to a $300 yearly limit, but individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H0028-082 (HMO) offers partially covered dental services up to a $1,750 annual maximum, with no copay and no coinsurance for most preventive, diagnostic, and comprehensive care. Medicare-covered dental requires a $35 copay and no coinsurance, prosthodontics require no copay and a 30% coinsurance, while fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H0028-082 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and other drugs, require no coinsurance to 20% coinsurance, while insulin has a $35 copay and no coinsurance to 20% coinsurance with no deductible.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H0028-082 (HMO) with no copay and a 20% coinsurance. Both prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H0028-082 (HMO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus H0028-082 (HMO) with prior authorization and referrals required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a copay between $0 and $170. Radiological services include outpatient X-rays with no copay, diagnostic radiological services starting at a $0 copay, and therapeutic radiological services with a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H0028-082 (HMO) with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H0028-082 (HMO) covers some cardiac rehabilitation services with no coinsurance and no copay, requiring both a referral and prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H0028-082 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, though a prior three-day inpatient hospital stay is not, and additional days beyond those covered by Medicare are not covered.
Other Services See details
Humana Gold Plus H0028-082 (HMO) provides partial coverage for other services, featuring acupuncture for a $35 copay and no coinsurance, and a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
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