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 Gulf 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 Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, you will pay no copay at standard pharmacies and through preferred mail order. If you use standard mail order, Tier 1 drugs require a $10 copay and Tier 2 drugs require a $20 copay for a one-month supply. For Tier 3 preferred brand drugs, copays are as low as $5 for a one-month supply at standard pharmacies and preferred mail order, but rise to $47 through standard mail order. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs carrying a 25% coinsurance.

Additional Benefits

The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive medical coverage with no copays or coinsurance for primary care visits, preventive services, home health, and cardiac rehabilitation. For hospital stays, members pay a $125 daily copay for the first six days of inpatient care and no copay thereafter, while outpatient hospital services range from no copay up to a $150 copay. Emergency care is available with a $150 copay, which is waived upon hospital admission, and urgent care requires a low $15 copay. Ancillary benefits include dental, vision, and hearing coverage, featuring no copays for routine exams, preventive dental care, and up to $300 annually for eyewear. Specialist visits and restorative dental services require low copays ranging from $15 to $35, while durable medical equipment and dialysis services generally require a 20% coinsurance with no copay. Additionally, the plan provides valuable extra benefits such as acupuncture, over-the-counter items, and up to 50 one-way transportation trips per year with no copay.