A non-government entity
Humana Gold Plus Giveback H1036-266 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Giveback H1036-266 (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 Giveback H1036-266 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus Giveback H1036-266 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Counties: CIT, HARD, HIG, PLK. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus Giveback H1036-266 (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 Giveback H1036-266 (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 Giveback H1036-266 (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 $131.90. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3400.00 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 Giveback H1036-266 (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 Giveback H1036-266 (HMO) plan features a $0 prescription drug deductible, allowing your coverage to begin immediately. You will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs for both one-month and three-month supplies at standard pharmacies and mail-order services. This plan offers a highly cost-effective option for individuals looking to minimize their everyday medication costs. For Tier 3 preferred brand drugs, there is a $30 copay for a one-month supply, while a three-month supply costs $90 at standard pharmacies or a discounted $60 through preferred mail order. Tier 4 non-preferred drugs require a 35% coinsurance, and Tier 5 specialty drugs carry a 33% coinsurance for a one-month supply. These clear pricing tiers help you accurately budget your healthcare expenses with the Humana Gold Plus Giveback H1036-266 (HMO) plan.
Additional Benefits
The Humana Gold Plus Giveback H1036-266 (HMO) plan offers robust medical coverage with no copay or coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, you will pay a $100 daily copay for the first six days and no copay for days seven through 90. Outpatient services feature no coinsurance and range from no copay to a $125 copay depending on the location of care. This plan also includes supplemental benefits, such as dental and vision care with no copay or coinsurance, including up to $1,000 for dental services and $200 for eyewear annually. Routine hearing exams are available with no copay, while prescription hearing aids require copays ranging from $199 to $1,299. Skilled nursing facility stays are covered with no copay for the first 20 days followed by a $160 daily copay for days 21 through 100.
Inpatient Hospital See details
Humana Gold Plus Giveback H1036-266 (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $100 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute 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 Giveback H1036-266 (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $125, observation services cost a $100 copay per stay, and outpatient substance abuse sessions have a copay of $30 to $35.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus Giveback H1036-266 (HMO) with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers ground ambulance services with a $0 to $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 50 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $15 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Primary care benefits under the Humana Gold Plus Giveback H1036-266 (HMO) feature no copay and no coinsurance for primary care physician visits, while specialists, therapies, and mental health services require copays ranging from $30 to $40 and no coinsurance. Additional telehealth services are covered with copays ranging from no copay to $30 and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering memory fitness and in-home support with no copay and no coinsurance, while sub-services such as health education, PERS, medical nutrition therapy, weight management, alternative therapies, and home safety modifications are not covered.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus Giveback H1036-266 (HMO), offering Medicare-covered exams for a $30 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered with no coinsurance and copays ranging from $199 to $1,299, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus Giveback H1036-266 (HMO) partially covers vision services, offering one routine eye exam per year with no copay and no coinsurance, while other eye exams are not covered. Covered eyewear—including contact lenses and eyeglasses (lenses and frames)—has no copay and no coinsurance up to a $200 annual maximum, though individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus Giveback H1036-266 (HMO) provides partially covered dental services up to a $1,000 annual limit, with no copay and no coinsurance for most preventive and comprehensive services, though fluoride, endodontics, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered. Medicare-covered dental services require a $30 copay and no coinsurance, while covered removable prosthodontics have no copay and a 30% coinsurance.
Home Infusion bundled Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and range from no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers dialysis services 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 Giveback H1036-266 (HMO) covers medical equipment, with durable medical equipment and diabetic supplies requiring a 20% coinsurance and no copay. Prosthetic devices carry a 20% coinsurance, while medical supplies and diabetic therapeutic shoes or inserts are covered with no copay, all requiring prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Humana Gold Plus Giveback H1036-266 (HMO) plan, requiring prior authorization and referrals. Lab services and outpatient X-rays feature no copay, diagnostic procedures range from a $0 to $180 copay with no coinsurance, and therapeutic radiological services require a minimum $30 copay and 20% minimum coinsurance.
Home Health Services See details
Home health services are covered under the Humana Gold Plus Giveback H1036-266 (HMO) plan with no copay and no coinsurance. Both prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Humana Gold Plus Giveback H1036-266 (HMO) covers some Cardiac Rehabilitation Services with no coinsurance, but requires prior authorization and a referral. However, cardiac, intensive cardiac, and pulmonary rehabilitation services (which carry a $20 copay) and SET for PAD services (which carry a $30 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Giveback H1036-266 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $160 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
Humana Gold Plus Giveback H1036-266 (HMO) partially covers other services, offering acupuncture with no copay and no coinsurance for up to 25 treatments per year, though prior authorization is required. Over-the-counter (OTC) items, meal benefits, and other additional services 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