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Humana Gold Plus Chronic Kidney Disease (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Chronic Kidney Disease (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 Chronic Kidney Disease (HMO C-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Jackson and Gulf Coast Mississippi. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus Chronic Kidney Disease (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 Chronic Kidney Disease (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 Chronic Kidney Disease (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 Chronic Kidney Disease (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.
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 $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 $9250.00 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 Chronic Kidney Disease (HMO C-SNP)
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Drug Coverage
The Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. Beneficiaries pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs when filled at a standard pharmacy or through preferred mail order. If you use standard mail order for these lower-tier drugs, one-month copays range from $10 to $20. Tier 3 preferred brand drugs have a $47 copay for a one-month supply across standard pharmacies and mail order options. For higher-tier medications, you will pay a 50% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) offers comprehensive medical coverage with affordable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a low $5 copay, while dialysis services are covered with a $20 copay and no coinsurance. Emergency care carries a $115 copay, and inpatient hospital stays require a $489 copay for days 1 to 5 of acute stays with no coinsurance. Additional benefits include routine vision and hearing exams, as well as dental coverage up to a $1,500 annual limit, all featuring no copay and no coinsurance. Members also benefit from unlimited one-way transportation to approved medical locations and over-the-counter items with no copay. For medical equipment, diabetic supplies have no copay and no coinsurance, while durable medical equipment requires a 20% coinsurance with no copay.
Inpatient Hospital See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers inpatient hospital stays with no coinsurance, requiring a $489 copay for days 1 to 5 of acute stays and a $416 copay for days 1 to 5 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and psychiatric stays beyond 90 days are not covered.
Outpatient Services See details
Outpatient services covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) feature no coinsurance, with no copays for ambulatory surgical center and blood services. Outpatient hospital services have a copay of $0 to $435, outpatient substance abuse sessions require a $35 copay, and observation services carry a $489 copay per stay, with prior authorization required for most services.
Partial Hospitalization See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers partial hospitalization with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan, with Medicare-covered ground and air ambulance services requiring a $290 copay and no coinsurance. The plan also provides partial transportation coverage, offering unlimited one-way rides to plan-approved health-related locations with no copay and no coinsurance, while trips to non-approved locations are not covered.
Emergency Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $5 copay and no coinsurance. Other covered services like therapy, mental health, podiatry, and telehealth feature copays ranging from no copay up to $40 and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers preventive services, annual physical exams, kidney disease education, and select screenings with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan, featuring a $5 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine annual exams and fittings. Prescription hearing aids are partially covered with copays ranging from $399 to $999 and no coinsurance (inner ear, outer ear, and over-the-ear types 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 Chronic Kidney Disease (HMO C-SNP) with no coinsurance and copays ranging from no copay to $5. Routine exams and eyewear are covered up to a $150 annual limit, but other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) partially covers dental services, featuring a $1,500 annual limit for non-Medicare services with no copay and no coinsurance, while Medicare-covered dental requires a $5 copay and no coinsurance. Fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, 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
The Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers dialysis services with a $20 copayment and no coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment is covered under the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP), with durable medical equipment and prosthetics requiring a 20% coinsurance and no copay. Diabetic equipment and supplies are also covered with no copay and no coinsurance, though prior authorization is required and manufacturer limitations apply.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP), with prior authorization required for all services. Outpatient diagnostic procedures and tests have a copay of $0 to $105 with no coinsurance, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance and a $5 copay.
Home Health Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) with no coinsurance and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and carry a $10 copay.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a 3-day prior inpatient hospital stay is not needed, additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) partially covers other services, offering acupuncture for a $5.00 copay and no coinsurance, as well as over-the-counter items and meal benefits with no copay and no coinsurance. Other unspecified supplemental services and dual-eligible highly integrated services are not covered.
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