A non-government entity
Humana Gold Plus Giveback H1036-334 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Giveback H1036-334 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus Giveback H1036-334 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus Giveback H1036-334 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Tidewater. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus Giveback H1036-334 (HMO) 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 Giveback H1036-334 (HMO).
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 Giveback H1036-334 (HMO), 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 $129.00. 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 $450.00 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 Giveback H1036-334 (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus Giveback H1036-334 (HMO) plan features a $450 annual drug deductible. For Tier 1 preferred generics and Tier 2 generics, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. If you use standard mail order, these generic drugs cost a $10 to $20 copay for a 1-month supply. For Tier 3 preferred brand drugs, you will pay a $47 copay for a 1-month supply, or $131 for a 3-month supply when using preferred mail order. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs requiring 44% coinsurance and Tier 5 specialty drugs requiring 27% coinsurance for a 1-month supply.
Additional Benefits
The Humana Gold Plus Giveback H1036-334 (HMO) plan offers robust coverage with no copay for primary care visits, preventive services, and routine dental and vision care. For specialist visits, patients will pay a $40 copay, while inpatient hospital stays require a $375 daily copay for the first several days before transitioning to no copay. Emergency care carries a $115 copay, which is waived upon hospital admission, and ambulance services require a $335 copay with no coinsurance. Diagnostic lab services, home health care, and the first 20 days of a skilled nursing facility stay are also available with no copay. For medical equipment and dialysis, you will pay a 20% coinsurance and no copay, while prescription hearing aids require a copay of $699 to $999. Other diagnostic tests carry a copay up to $120 with no coinsurance, helping keep your out-of-pocket costs predictable.
Inpatient Hospital See details
Humana Gold Plus Giveback H1036-334 (HMO) inpatient hospital benefits are partially covered with no coinsurance, requiring prior authorization. You will pay a $375 daily copay for days 1 to 7 of acute stays and days 1 to 5 of psychiatric stays, with no copay for remaining covered days; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus Giveback H1036-334 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services carry a copay of $0 to $450, observation services have a $375 copay per stay, and outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
The Humana Gold Plus Giveback H1036-334 (HMO) plan covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by Humana Gold Plus Giveback H1036-334 (HMO) with a $335 copay and no coinsurance for both ground and air transport, which requires prior authorization. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Humana Gold Plus Giveback H1036-334 (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus Giveback H1036-334 (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $40 copay and no coinsurance. Other covered services, such as physical therapy, occupational therapy, and mental health services, range from a $25 to $35 copay with no coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the Humana Gold Plus Giveback H1036-334 (HMO), offering no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, and diabetes self-management. However, additional preventive sub-services such as fitness benefits, health education, in-home safety assessments, and medical nutrition therapy are not covered.
Hearing Services See details
Humana Gold Plus Giveback H1036-334 (HMO) covers hearing services, offering routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Prescription hearing aids are partially covered with a copay of $699 to $999 and no coinsurance for up to two aids yearly, but OTC hearing aids as well as inner-ear, outer-ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by Humana Gold Plus Giveback H1036-334 (HMO), featuring routine eye exams and select eyewear with no copay and no coinsurance, up to a $150 annual limit. Covered eye exams have copays ranging from no copay to $40 with no coinsurance, while other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the Humana Gold Plus Giveback H1036-334 (HMO) plan, featuring Medicare-covered dental for a $40 copay and no coinsurance, and other dental services with no copay and no coinsurance. While many diagnostic, preventive, and restorative services are covered, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus Giveback H1036-334 (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B chemotherapy, insulin, and other drugs require no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis services are covered by the Humana Gold Plus Giveback H1036-334 (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to access these covered services.
Medical Equipment See details
Medical Equipment is covered under the Humana Gold Plus Giveback H1036-334 (HMO) plan, featuring a 20% coinsurance and no copay for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies require a 10% to 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts have a $10 copay, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
Humana Gold Plus Giveback H1036-334 (HMO) covers diagnostic and radiological services, with prior authorization required. Lab services and outpatient X-rays have no copay, while diagnostic procedures and tests carry no coinsurance and a copay of $0 to $120. Therapeutic radiological services require a minimum $40 copay and 20% coinsurance, and diagnostic radiology has a minimum copay of $0.
Home Health Services See details
The Humana Gold Plus Giveback H1036-334 (HMO) plan 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 under the Humana Gold Plus Giveback H1036-334 (HMO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Giveback H1036-334 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and requires prior authorization, but does not require a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
Humana Gold Plus Giveback H1036-334 (HMO) provides partial coverage for other services, including acupuncture for a $40.00 copay and no coinsurance up to 20 treatments per year, and meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan, and prior authorization is required for the covered benefits.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved