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Humana Dual Integrated (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Integrated (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 Integrated (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Dual Integrated (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Southeast Florida. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Humana Dual Integrated (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 Integrated (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 Integrated (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 Integrated (HMO D-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 no drug deductible. Your prescription medication coverage will start immediately.
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:
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Drug Coverage
The Humana Dual Integrated (HMO D-SNP) prescription drug plan features a $0 annual deductible, meaning your coverage begins immediately. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay for both 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. Standard mail order for these tiers requires a copay, ranging from $10 to $20 for a 1-month supply and $30 to $60 for a 3-month supply. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand and Tier 4 non-preferred drugs require a 25% coinsurance for both 1-month and 3-month supplies at standard pharmacies and mail order services. Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply across all available pharmacy and mail order options.
Additional Benefits
The Humana Dual Integrated (HMO D-SNP) plan offers comprehensive medical coverage, featuring no copay and a 20% coinsurance for outpatient services, primary care, specialist visits, and dialysis. Emergency care is available with a $115 copay, which is waived if you are admitted, while acute inpatient hospital stays require a $2,230 copay per stay with no coinsurance. Additionally, skilled nursing facility stays offer no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. For supplemental care, the plan provides no copay and no coinsurance for home health services, routine preventive care, and select over-the-counter items. Dental benefits are covered up to a $5,000 annual limit, featuring no copay and no coinsurance for most preventive and comprehensive services. Vision and hearing benefits are also highly accessible, offering no copay and no coinsurance for eyewear up to $400 yearly and hearing aids up to $1,000 per ear annually.
Inpatient Hospital See details
Humana Dual Integrated (HMO D-SNP) covers acute inpatient hospital stays with a $2,230 copay per stay, no coinsurance, and no copay for unlimited additional days, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric stays are covered with a $2,080 copay per stay and no coinsurance, but additional days and non-Medicare-covered stays are excluded. Prior authorization is required for both services, and there is no cost sharing on the day of discharge.
Outpatient Services See details
Humana Dual Integrated (HMO D-SNP) covers outpatient services with no copays and a 20% coinsurance for outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. These covered services require prior authorization and referrals, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Humana Dual Integrated (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Humana Dual Integrated (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Humana Dual Integrated (HMO D-SNP) 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 are covered with a 20% coinsurance (up to $40 per visit) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Dual Integrated (HMO D-SNP) covers primary care, specialist, mental health, therapy, podiatry, and telehealth services with no copay and a 20% coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Humana Dual Integrated (HMO D-SNP) covers preventive services, such as annual physical exams and kidney disease education, with no copay and no coinsurance. However, additional preventive benefits are only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, caregiver support, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety modifications, and counseling are not covered.
Hearing Services See details
Humana Dual Integrated (HMO D-SNP) covers hearing services, including routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, though inner ear, outer ear, and over-the-ear types are not covered. OTC hearing aids are also covered with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by Humana Dual Integrated (HMO D-SNP), featuring routine eye exams with no copay and a 20% coinsurance (limited to one per year) and eyewear with no copay and no coinsurance up to a $400 yearly limit. Other eye exams, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Humana Dual Integrated (HMO D-SNP) offers partially covered dental services with a $5,000 annual maximum, featuring no copay and a 20% coinsurance for Medicare-covered dental services, and no copay and no coinsurance for most other preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Humana Dual Integrated (HMO D-SNP) covers home infusion bundled services, which require prior authorization and may involve step therapy. Covered Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while other Part B drugs carry 0% to 20% coinsurance with either no copay or an applicable copay for chemotherapy and radiation treatments.
Dialysis Services See details
Dialysis services are covered by the Humana Dual Integrated (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Humana Dual Integrated (HMO D-SNP) covers durable medical equipment, prosthetic devices, and medical supplies with a 20% coinsurance and no copay, subject to prior authorization. Diabetic supplies and therapeutic shoes are also covered with no copay and no coinsurance, though prior authorization is required and selection is limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Dual Integrated (HMO D-SNP) covers diagnostic and radiological services, which require referrals and prior authorization. Diagnostic procedures and tests require a copayment and a minimum 20% coinsurance, while lab services, X-rays, and radiological services feature no copay and a minimum 20% coinsurance.
Home Health Services See details
Humana Dual Integrated (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Both prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Humana Dual Integrated (HMO D-SNP) with no copay, but only some services are covered. Specifically, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Dual Integrated (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring 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 hospital stay is not needed, additional days beyond the standard 100 days are not covered.
Other Services See details
Humana Dual Integrated (HMO D-SNP) offers partial coverage for other services, featuring acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Prior authorization is required for meal benefits and acupuncture, which is limited to 25 treatments per year, while highly integrated services and other additional services are not covered.
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