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Humana Gold Plus H1951-013 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-013 (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 H1951-013 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-013 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Shreveport. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-013 (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 H1951-013 (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 H1951-013 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $5650.00 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 H1951-013 (HMO) prescription drug plan has an annual deductible of $615. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are available for a $5 copay for a 1-month supply at standard pharmacies and preferred mail order, with no copay for a 3-month supply through preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply, while a 3-month supply costs $131 through preferred mail order and $141 through standard pharmacies or mail order. For higher-tier medications, the plan charges a 47% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs. These cost-sharing tiers help you easily estimate your out-of-pocket expenses for prescriptions under this Humana Medicare plan.
Additional Benefits
The Humana Gold Plus H1951-013 (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay for primary care visits and a $30 copay for specialists. For inpatient hospital stays, members pay a $195 copay for days 1 through 7 and no copay for days 8 through 90. Standard preventive services, home health care, and up to 60 one-way transportation trips to approved locations are also covered with no copay. This plan also includes key supplemental benefits, such as dental care covered up to a $2,500 annual limit with no copay and vision eyewear covered up to $250. Routine hearing exams require no copay, while prescription hearing aids are available with a copay ranging from $699 to $999. Additionally, durable medical equipment and prosthetic devices are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H1951-013 (HMO) covers inpatient hospital and psychiatric stays with no coinsurance, requiring a $195 copay for days 1 to 7 and no copay for days 8 to 90. Prior authorization is required, and while unlimited additional acute days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H1951-013 (HMO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $135, outpatient substance abuse sessions have a $35 copay, and observation services carry a $195 copay per stay.
Partial Hospitalization See details
Humana Gold Plus H1951-013 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus H1951-013 (HMO), featuring a $335 copay for ground ambulance services and 20% coinsurance for air ambulance services. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any other health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H1951-013 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are available with a $50 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-013 (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Physical, occupational, and speech therapies require a $20 copay, while mental health, psychiatric, and opioid treatments have a $35 copay, all with no coinsurance. Podiatry is not covered, and although some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic services are not.
Preventive Services See details
Preventive services are covered by Humana Gold Plus H1951-013 (HMO) with no copay and no coinsurance for services like annual physicals, kidney disease education, and diabetes self-management. However, the benefit is only partially covered, as supplemental services like health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, chemo wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, tobacco cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Humana Gold Plus H1951-013 (HMO) offers partially covered hearing services, featuring no copay and no coinsurance for routine exams (one per year) and fitting evaluations, and a $30 copay with no coinsurance for Medicare-covered exams. Up to two prescription hearing aids are covered per year with no coinsurance and a copay ranging from $699 to $999, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H1951-013 (HMO) partially covers vision services, offering eye exams with a $0 to $30 copay and no coinsurance, and covered eyewear with no copay and no coinsurance up to a $250 annual limit. Other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H1951-013 (HMO), offering Medicare-covered dental care with a $30 copay and no coinsurance, and other covered dental services with no copay and no coinsurance up to a $2,500 annual limit. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H1951-013 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy, radiation, and other drugs, have a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H1951-013 (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H1951-013 (HMO) covers durable medical equipment (DME) and prosthetic devices with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and a 10% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-013 (HMO) covers diagnostic and radiological services with prior authorization required, featuring no coinsurance and a $0 to $50 copay for diagnostic procedures, and no copay for lab services and outpatient X-rays. Diagnostic radiological services start at no copay, while therapeutic radiological services require a minimum 20% coinsurance and a minimum $30 copay.
Home Health Services See details
Humana Gold Plus H1951-013 (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-013 (HMO) covers some Cardiac Rehabilitation Services with no coinsurance and a $15 copay, subject to prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H1951-013 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not necessary, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Gold Plus H1951-013 (HMO), offering acupuncture for a $30 copay and no coinsurance for up to 20 treatments per year, and chronic illness meals with no copay and no coinsurance. Over-the-Counter (OTC) items are not covered under this benefit.
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