Humana Gold Plus SNP-DE H1036-210 (HMO D-SNP)

Humana Gold Plus SNP-DE H1036-210 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Jacksonville Metro area. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that Humana Gold Plus SNP-DE H1036-210 (HMO D-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 SNP-DE H1036-210 (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.

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 SNP-DE H1036-210 (HMO D-SNP) features a $0 drug deductible, allowing your prescription drug coverage to start right away. For Tier 1 preferred generic and Tier 2 generic drugs, there is no copay for a 1-month or 3-month supply when using a standard pharmacy or preferred mail order. However, standard mail order for these tiers requires a copay, ranging from $10 to $30 for Tier 1 and $20 to $60 for Tier 2 depending on the supply duration. For Tier 3 preferred brand and Tier 4 non-preferred drugs, you will pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and all mail order options. Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply through standard pharmacies, preferred mail order, and standard mail order.

Additional Benefits

The Humana Gold Plus SNP-DE H1036-210 (HMO D-SNP) offers highly comprehensive coverage with no copay and no coinsurance for most medical services, including inpatient and outpatient hospital care, primary care, and preventive visits. Members also benefit from no copays or coinsurance for diagnostics, home health care, durable medical equipment, and skilled nursing facility stays up to 100 days. While most services have no cost-sharing, emergency services require a $130 copay, which is waived if you are admitted within 24 hours, and air ambulance services carry a 20% coinsurance. This plan also features robust supplemental benefits, including dental coverage with no copay or coinsurance up to a $3,000 annual limit and a $400 annual vision allowance for eyeglasses or contacts. Additionally, members receive prescription hearing aid coverage up to $1,000 per ear annually with no copay or coinsurance. Other valuable perks include covered transportation to plan-approved locations, over-the-counter item reimbursements, and acupuncture treatments with no copay.