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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 South Carolina. The overall rating for this plan is not yet available for 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 $5.10. 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:
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Drug Coverage
The Humana Dual Integrated (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy no copay when using standard pharmacies or preferred mail order services. If you choose standard mail order for these generic drugs, copays range from $10 to $20 for a 1-month supply. For higher-tier medications, including Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan requires a consistent 25% coinsurance. This 25% coinsurance applies across standard pharmacies, preferred mail order, and standard mail order options. This clear structure helps you easily project your out-of-pocket costs for brand-name and specialty prescriptions.
Additional Benefits
The Humana Dual Integrated (HMO D-SNP) plan offers comprehensive coverage with varying cost-sharing structures depending on the service. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care, while outpatient services, primary care, and specialist visits feature no copay but require a 20% coinsurance. Emergency department visits carry a $115 copay, which is waived if you are admitted, and ambulance services require a $335 copay with no coinsurance. For everyday wellness, the plan provides preventive care, home health services, and hearing aids with no copay and no coinsurance. Vision and dental benefits are partially covered, offering up to $450 annually for eyewear and up to $1,500 annually for dental services with no copay and no coinsurance for most preventive care. Additionally, members can access over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, though many specialized services require prior authorization.
Inpatient Hospital See details
Humana Dual Integrated (HMO D-SNP) partially covers inpatient hospital services, which require a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, with no coinsurance and prior authorization required for both. While unlimited additional acute care days are covered, upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Dual Integrated (HMO D-SNP) covers outpatient services with no copays, though a 20% coinsurance and prior authorization are required for outpatient hospital, ambulatory surgical center, substance abuse, and blood services. There is no deductible for outpatient blood services, and the cost of the first three pints of blood is waived.
Partial Hospitalization See details
Partial hospitalization is covered by the Humana Dual Integrated (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Humana Dual Integrated (HMO D-SNP) covers ground and air ambulance services with a $335.00 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Humana Dual Integrated (HMO D-SNP) covers emergency department visits 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 no copay and a 20% coinsurance up to $40 per visit, 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 visits, therapies, mental health, telehealth, and opioid treatment with no copay and 20% coinsurance. Podiatry and chiropractic services, including routine chiropractic care, are not covered.
Preventive Services See details
Humana Dual Integrated (HMO D-SNP) offers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. While a memory fitness program is covered with no copay, several other supplemental benefits like health education, weight management, and in-home support are not covered.
Hearing Services See details
Humana Dual Integrated (HMO D-SNP) offers partially covered hearing services with no deductible, including routine hearing exams once per year with a 20% coinsurance and no copay, and unlimited fitting evaluations with no copay and no coinsurance. Prescription hearing aids (up to two every three years) and OTC hearing aids are covered with no copay and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Dual Integrated (HMO D-SNP) partially covers vision services with no deductibles, offering one routine eye exam per year with no copay and 20% coinsurance, and up to $450 annually for eyewear with no copay or coinsurance. Other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services under the Humana Dual Integrated (HMO D-SNP) are partially covered up to a $1,500 annual limit, featuring no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require a 20% coinsurance and no copay. Fluoride treatments, orthodontics, implants, fixed prosthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Humana Dual Integrated (HMO D-SNP) covers home infusion bundled services with prior authorization, applying a coinsurance of no coinsurance to 20% for Part B chemotherapy, radiation, and other drugs. Covered insulin requires a $35 copay and up to 20% coinsurance, while other Part B drugs feature no copay and up to 20% coinsurance.
Dialysis Services See details
Humana Dual Integrated (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Dual Integrated (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with a 20% coinsurance and no copays. Prior authorization is required for most of these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Dual Integrated (HMO D-SNP) with a 20% coinsurance and require prior authorization. Diagnostic procedures and lab services require no copay, while outpatient X-rays have a $50 copay and diagnostic radiological services have a $200 copay.
Home Health Services See details
Home Health Services are covered by Humana Dual Integrated (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Dual Integrated (HMO D-SNP) covers some cardiac rehabilitation services with no copay and prior authorization, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Dual Integrated (HMO D-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered 100-day limit are not covered.
Other Services See details
Humana Dual Integrated (HMO D-SNP) provides partial coverage for other services, including acupuncture with no copay and 20% coinsurance for up to 20 treatments per year, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, while highly integrated services and other additional services are not covered.
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