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Humana Dual Select H1036-307 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Select H1036-307 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Dual Select H1036-307 (HMO D-SNP) in 2025, please refer to our full plan details page.
Humana Dual Select H1036-307 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in North Carolina. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Humana Dual Select H1036-307 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Dual Select H1036-307 (HMO D-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 Dual Select H1036-307 (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.
For Humana Dual Select H1036-307 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.20. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $590.00 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 $9350.00 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:
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Drug Coverage
The Humana Dual Select H1036-307 (HMO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you have LIS, the monthly premium for Part D is $51.20.
Additional Benefits
The Humana Dual Select H1036-307 (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. This plan features no copays for primary care visits, preventive services, home health services, routine hearing exams, fitting/evaluation for hearing aids, eyewear, and many dental services. You'll pay a copay for inpatient hospital stays, outpatient services, specialist visits, mental health services, ambulance services, emergency services, and other services. The plan also provides coverage for services like hearing exams, vision exams, and medical equipment, often with copays or coinsurance. Additionally, the plan covers diagnostic and radiological services, skilled nursing facility stays, and offers extra benefits like acupuncture, over-the-counter items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric care, with a copay of $399 per admission for days 1-6 for acute care and days 1-5 for psychiatric care, and no copay for days 7-90 of acute care or days 6-90 of psychiatric care. Additional days for acute inpatient hospital stays have no copay, while non-Medicare-covered stays and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient hospital services and outpatient substance abuse services have copays ranging from $0 to $450, while observation services have a $399 copay; Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Individual and group sessions for outpatient substance abuse have copays between $45 and $100.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan, but requires prior authorization. The copay for this benefit is $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan. Ground and air ambulance services each have a $315 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Humana Dual Select H1036-307 (HMO D-SNP). Emergency Services have a $110 copay, and no coinsurance. Urgently Needed Services have a $45 copay, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay, and no coinsurance.
Primary Care See details
The Humana Dual Select H1036-307 (HMO D-SNP) plan covers primary care physician services with no copay. Chiropractic services have a $15 copay, while occupational therapy services have a $25 copay. Physician specialist services and physical therapy/speech-language pathology services have a $25 copay. Mental health and psychiatric services have a copay of $45. Additional telehealth benefits have a copay between $0 and $45, and opioid treatment program services have a copay between $45 and $100. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, Annual Physical Exams with no copay, and additional preventive services like Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Health Education, In-Home Safety Assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
Hearing Services include Hearing Exams with a $25 copay, Routine Hearing Exams with no copay, and Fitting/Evaluation for Hearing Aid with no copay. Prescription Hearing Aids (all types) are covered with no copay, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC Hearing Aids are also not covered.
Vision Services See details
Vision Services include coverage for eye exams with a copay between $0 and $25, and eyewear with no copay, including contact lenses and eyeglasses (lenses and frames). Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Dual Select H1036-307 (HMO D-SNP) covers Medicare Dental Services with a $25 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, and oral and maxillofacial surgery with no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%, and Other Medicare Part B Drugs have no copay.
Dialysis Services See details
Dialysis Services are covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan, with a 20% coinsurance for Durable Medical Equipment, Medical Supplies, and Prosthetic Devices. Diabetic Supplies have a 20% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
The Humana Dual Select H1036-307 (HMO D-SNP) plan covers diagnostic and radiological services, including diagnostic procedures and tests with a copay of up to $120 and a coinsurance of at most 20%, lab services with no copay, diagnostic radiological services with a copay of up to $325, therapeutic radiological services with a copay of up to $25 and a coinsurance of at most 20%, and outpatient X-ray services with no copay.
Home Health Services See details
Home Health Services are covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Dual Select H1036-307 (HMO D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214, with no coinsurance.
Other Services See details
The Humana Dual Select H1036-307 (HMO D-SNP) plan covers acupuncture with a $25 copay and a limit of 20 treatments per year, as well as over-the-counter items up to $1200 per year. The plan also offers a meal benefit with no copay. Some other services are not covered.
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