Humana Gold Plus SNP-DE H1036-226 (HMO D-SNP)

Humana Gold Plus SNP-DE H1036-226 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Treasure 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 H1036-226 (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 H1036-226 (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 H1036-226 (HMO D-SNP) features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members pay no copay for one-month and three-month supplies filled at standard pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, copays range from $10 to $60 depending on the tier and supply. For Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance applies to standard pharmacies, preferred mail order, and standard mail order options. Specialty tier medications are limited to a one-month supply under these cost-sharing terms.

Additional Benefits

The Humana Gold Plus SNP-DE H1036-226 (HMO D-SNP) offers comprehensive coverage with no copays and no coinsurance for most medical services. Members benefit from no copays on primary and specialist care, preventive screenings, medical equipment, and home health services. For specific major services, costs are limited to a $100 copay for the first seven days of inpatient hospital stays and a $115 copay for emergency room visits. This plan also includes generous supplemental benefits for dental, vision, and hearing care with no copays or coinsurance. Covered members receive up to a $3,000 annual limit for dental services, a $400 annual limit for vision eyewear, and up to $1,000 per ear annually for prescription hearing aids. Additional perks include no-copay ground ambulance, unlimited transportation to plan-approved locations, and acupuncture treatments.