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Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus - Diabetes and Heart (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus - Diabetes and Heart (HMO C-SNP) in 2026, please refer to our full plan details page.
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 Greater Tampa Bay. 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.
Important:
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
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.
For Humana Gold Plus - Diabetes and Heart (HMO C-SNP), 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 $177.00. 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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2000.00 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 - Diabetes and Heart (HMO C-SNP)
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Drug Coverage
The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generics and Tier 2 generics at standard pharmacies and through preferred mail order. Additionally, Tier 6 select care drugs are available with no copay across all standard pharmacy and mail order options. Tier 3 preferred brand drugs require a copay starting at $30 for a one-month supply at standard pharmacies and preferred mail order. For higher-tier medications, Tier 4 non-preferred drugs carry a 47% coinsurance, while Tier 5 specialty tier drugs require a 25% coinsurance. These cost-sharing details help you estimate your out-of-pocket prescription costs under this Humana HMO C-SNP plan.
Additional Benefits
The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits and routine preventive services. Specialist visits require a low $10 copay, while inpatient hospital stays cost a $75 daily copay for the first four days followed by no copay for days five through 90. Emergency care is available with a $150 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable dental, vision, and hearing benefits, featuring no copays for routine dental care up to a $2,000 annual limit and no copays for routine eye exams. Hearing care features no copays for routine exams and over-the-counter hearing aids, while prescription hearing aids require copays ranging from $199 to $1299. Additionally, home health services and skilled nursing facility stays for the first 20 days are covered with no copay or coinsurance.
Inpatient Hospital See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $75 daily copay for days 1 through 4 and no copay for days 5 through 90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no coinsurance, featuring copays ranging from $0 to $150 for outpatient hospital services and a $75 copay per stay for observation services. There is no copay or coinsurance for ambulatory surgical center and blood services, while outpatient substance abuse services have no coinsurance and a copay of $0 to $10 per session.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with a $35.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers ground ambulance services with a $0 to $200 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, but trips to any health-related location are not covered.
Emergency Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) 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 are covered with a $15 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services each require a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 copay and no coinsurance. Additional professional services, including physical therapy, mental health, and telehealth, feature copays ranging from $0 to $30 with no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) provides covered preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. However, additional preventive benefits are only partially covered, with services such as health education, weight management programs, and personal emergency response systems not covered.
Hearing Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $10 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $199 to $1299 and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered, while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
Vision services are partially covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no deductibles, featuring no copay for routine eye exams (up to a $10 copay for other exams), no coinsurance, and no copay or coinsurance for eyewear up to a $200 annual limit. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) offers partially covered dental services up to a $2,000 annual limit, featuring no copay and no coinsurance for most preventive, diagnostic, and restorative care, though Medicare-covered dental services require a $10 copay and no coinsurance. Prosthodontics are covered with no copay and a 30% coinsurance, while fluoride treatments, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs require coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers durable medical equipment and diabetic supplies with a 20% coinsurance and no copay. Prosthetics, medical supplies, and diabetic therapeutic shoes are also covered with no copay, though prior authorization is required for most medical equipment.
Diagnostic and Radiological Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers diagnostic and radiological services, with no copay for lab work and outpatient X-rays. Diagnostic tests range from a $0 to $200 copay with no coinsurance, while therapeutic radiology requires a minimum 20% coinsurance and a $10 copay.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan with no copay and no coinsurance. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $160 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the 100 Medicare-covered days are not covered.
Other Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) provides coverage for other services with no copay and no coinsurance, including up to 25 acupuncture treatments per year, over-the-counter items, and meal benefits for chronic conditions. Prior authorization is required for acupuncture and meals, while highly integrated dual eligible SNP services and other miscellaneous services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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* 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.
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