Humana Gold Plus SNP-DE H1036-214 (HMO D-SNP)

Humana Gold Plus SNP-DE H1036-214 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Emerald Coast. 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 H1036-214 (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 H1036-214 (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 H1036-214 (HMO D-SNP) prescription drug plan has an annual drug deductible of $305. Under this plan, Tier 1 preferred generic and Tier 2 generic medications have no copay for one-month and three-month supplies filled at standard pharmacies or through preferred mail order. However, standard mail order delivery for these generic tiers requires a copay ranging from $10 to $60 depending on the tier and supply duration. For brand-name and specialty medications, costs are based on coinsurance rather than copays. Tier 3 preferred brands and Tier 4 non-preferred drugs require a 25% coinsurance for standard pharmacy and mail order options. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply at standard pharmacies and mail order services.

Additional Benefits

The Humana Gold Plus SNP-DE H1036-214 (HMO D-SNP) plan offers comprehensive coverage with no copays and no coinsurance for most essential healthcare services. This includes zero-cost benefits for inpatient hospital stays, outpatient care, primary and specialist visits, preventive services, and home health care. Additionally, members can access diagnostic testing, medical equipment, and dialysis with no out-of-pocket costs, though some services require prior authorization. For supplemental care, the plan features a $3,000 annual limit for dental services, a $400 yearly allowance for eyewear, and up to $1,250 per ear every two years for prescription hearing aids with no copays. Emergency room visits carry a $115 copay, which is waived if you are admitted within 24 hours, while ground ambulance services range from a $0 to $100 copay. Members also benefit from unlimited transportation to plan-approved locations and covered over-the-counter items at no extra cost.