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Humana Gold Plus Lung (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Lung (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 Lung (HMO C-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus Lung (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 Lung (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 Lung (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 Lung (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 Lung (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 $175.00. 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:
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Drug Coverage
The Humana Gold Plus Lung (HMO C-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, there is no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs filled at standard pharmacies or through preferred mail order. Additionally, Tier 6 (Select Care Drugs) are available with no copay across standard pharmacies, preferred mail order, and standard mail order services. For Tier 3 (Preferred Brand) drugs, you will pay a $47 copay for a one-month supply at standard pharmacies and mail order, though a preferred mail-order three-month supply reduces costs to a $94 copay. Higher-tier prescriptions require coinsurance rather than flat copays, with Tier 4 (Non-Preferred) drugs charging 48% coinsurance and Tier 5 (Specialty) drugs requiring 25% coinsurance.
Additional Benefits
The Humana Gold Plus Lung (HMO C-SNP) plan offers robust medical coverage featuring no copay for primary care visits, preventive services, and home health care. Specialists require a low $10 copay, while inpatient hospital stays cost a $100 daily copay for the first four days followed by no copay for days five through ninety. Emergency room visits carry a $150 copay, which is waived upon admission, and urgent care services are available for a $15 copay. In addition to core medical care, this plan provides valuable extra benefits including comprehensive dental services up to a $2,000 annual limit and routine vision exams with a $200 eyewear allowance, both with no copay. Routine hearing exams and over-the-counter hearing aids also feature no copay, while up to 50 one-way transportation trips to approved locations are included yearly with no copay. Beneficiaries will also enjoy no copay for acupuncture, chronic illness meal benefits, and select over-the-counter items.
Inpatient Hospital See details
Humana Gold Plus Lung (HMO C-SNP) inpatient hospital services are partially covered with no coinsurance, requiring a $100 daily copay for days 1 through 4 and no copay for days 5 through 90. Non-Medicare-covered stays, facility upgrades, and additional psychiatric stay days are not covered under this benefit.
Outpatient Services See details
Humana Gold Plus Lung (HMO C-SNP) covers outpatient services with no coinsurance, including a $0 to $150 copay for hospital services and a $100 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $0 to $10 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Humana Gold Plus Lung (HMO C-SNP) with a $35.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus Lung (HMO C-SNP) covers ground ambulance services with a copay of $0 to $200 and air ambulance services with a 20% coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 50 yearly one-way trips to plan-approved locations, while trips to any health-related location are not covered.
Emergency Services See details
Humana Gold Plus Lung (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, and transportation services are available with a $150 copay and no coinsurance.
Primary Care See details
Primary care benefits under the Humana Gold Plus Lung (HMO C-SNP) plan include primary care provider visits with no copay and no coinsurance, and specialist visits with a $10 copay and no coinsurance. Additional services like therapy, telehealth, and podiatry feature copays ranging from $0 to $30 with no coinsurance, though some chiropractic services are covered but routine chiropractic care and other chiropractic services are not.
Preventive Services See details
Humana Gold Plus Lung (HMO C-SNP) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering fitness and in-home support with no copay and no coinsurance, but excluding sub-services such as health education, nutritional therapy, personal emergency response systems, weight management, and home safety devices.
Hearing Services See details
Humana Gold Plus Lung (HMO C-SNP) covers Medicare-covered hearing exams with a $10 copay and routine exams or fittings with no copay, all with no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $199 to $1,299 (inner ear, outer ear, and over-the-ear models are not covered), while over-the-counter hearing aids are covered with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by Humana Gold Plus Lung (HMO C-SNP), offering one routine eye exam per year and select eyewear with no copay, no coinsurance, and no deductible. While contact lenses and eyeglasses (lenses and frames) are covered up to a $200 annual limit, other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus Lung (HMO C-SNP) partially covers dental services up to a $2,000 annual limit, offering most preventive and comprehensive care with no copay and no coinsurance. Medicare-covered dental services require a $10 copay and no coinsurance, prosthodontics require a 30% coinsurance and no copay, while fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus Lung (HMO C-SNP) covers Home Infusion bundled Services with no copay, although prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus Lung (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
Humana Gold Plus Lung (HMO C-SNP) covers durable medical equipment and diabetic supplies with a 20% coinsurance and no copay, while prosthetics and medical supplies feature no copay and no coinsurance. Diabetic therapeutic shoes and inserts are also covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus Lung (HMO C-SNP), requiring prior authorization and referrals. Diagnostic procedures range from no copay to a $200 copay with no coinsurance, lab services feature no copay and no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance and $10 copay.
Home Health Services See details
Humana Gold Plus Lung (HMO C-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Humana Gold Plus Lung (HMO C-SNP) covers some cardiac rehabilitation services with a $10 copay and no coinsurance, though prior authorization and referrals are required. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Lung (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $160 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus Lung (HMO C-SNP) provides partial coverage for Other Services with no copay and no coinsurance for acupuncture (up to 25 treatments per year), over-the-counter items, and meal benefits for chronic illnesses. Prior authorization is required for acupuncture and meal benefits, while sub-services listed as Other 1, Other 2, Other 3, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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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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