Humana Gold Plus - Diabetes and Heart (HMO C-SNP)

Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is a HMO C-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 - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-SNP) plan features an annual drug deductible of $615. For lower-tier medications, members benefit from affordable options, including no copay for Tier 1 preferred generics and Tier 6 select care drugs at standard pharmacies and preferred mail-order services. Tier 2 generic medications are also highly accessible, costing as little as a $5 copay for a one-month supply or no copay for a three-month supply via preferred mail order. For brand-name and higher-tier medications, Tier 3 preferred brands require a $35 copay for a one-month supply at standard pharmacies or through preferred mail order. More expensive prescriptions fall under coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs carrying a 25% coinsurance. Utilizing preferred mail-order services generally offers the best savings for long-term prescriptions under this plan.

Additional Benefits

The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive medical coverage with low out-of-pocket costs, featuring no copay and no coinsurance for primary care visits and preventive services. For inpatient hospital stays, members pay a daily copay of $225 for the first six days and no copay for days seven through 90. Outpatient services generally carry no coinsurance, with copays ranging from no copay for ambulatory surgical centers up to $250 for outpatient hospital services. Specialist visits, physical therapy, and mental health sessions require a $20 copay, while dialysis and durable medical equipment involve a 20% coinsurance with no copay. Essential routine benefits are also highly affordable, including no copay for preventive dental up to a $1,000 annual limit, routine vision exams and eyewear up to $50, and routine hearing exams. Additionally, members can access over-the-counter items, meal benefits, and home health services with no copay and no coinsurance.