A non-government entity
Humana Gold Plus H1951-028 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-028 (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 H1951-028 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-028 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Washington and St. Tammany Parishes. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-028 (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 H1951-028 (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 H1951-028 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.00. 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 $4500.00 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 H1951-028 (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 H1951-028 (HMO) prescription drug plan features an annual drug deductible of $615. Tier 1 preferred generic drugs have no copay for one-month or three-month supplies filled at standard pharmacies or through preferred mail order. Tier 2 generic drugs cost as little as a $5 copay for a one-month supply at standard pharmacies and preferred mail order, and there is no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a one-month supply across standard pharmacies, preferred mail order, and standard mail order. For higher-tier medications, Tier 4 non-preferred drugs require 50% coinsurance for both one-month and three-month supplies. Tier 5 specialty drugs require 25% coinsurance for a one-month supply across all available pharmacy and mail-order options.
Additional Benefits
The Humana Gold Plus H1951-028 (HMO) plan offers affordable healthcare coverage with no copay for primary care visits and a $35 copay for specialist visits. Inpatient hospital stays require a $195 daily copay for days 1 through 14, while days 15 and beyond require no copay. Emergency room visits feature a $130 copay that is waived if you are admitted, and outpatient surgical services require no copay. For supplemental care, the plan provides dental benefits up to a $3,000 annual limit with no copay for most services, alongside routine vision and hearing exams with no copay. Routine eyewear is covered up to $300 annually with no copay, while prescription hearing aids require a copay between $699 and $999. Durable medical equipment and dialysis services are covered with a 20% coinsurance, and skilled nursing facility stays have no copay for the first 20 days.
Inpatient Hospital See details
Humana Gold Plus H1951-028 (HMO) covers inpatient acute hospital stays with no coinsurance, requiring a $195 copay for days 1 through 14 and no copay for days 15 and beyond. Inpatient psychiatric care is also covered with no coinsurance, requiring a $168 copay for days 1 through 14 and no copay for days 15 through 90, though upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H1951-028 (HMO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $275, observation services carry a $195 copay per stay, and outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H1951-028 (HMO) with a $35.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-028 (HMO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services, including trips to plan-approved or any health-related locations, are not covered under this plan.
Emergency Services See details
Humana Gold Plus H1951-028 (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 require a $50 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-028 (HMO) offers primary care physician visits with no copay and no coinsurance, while specialist visits require a $35 copay and no coinsurance. Physical, occupational, and speech therapy services are covered with a $20 copay and no coinsurance, though chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Humana Gold Plus H1951-028 (HMO) offers partially covered preventive services with no copays and no coinsurance for covered care, which includes annual physical exams, kidney disease education, and diabetes self-management training. However, supplemental benefits such as health education, weight management programs, and personal emergency response systems are not covered under this plan.
Hearing Services See details
Humana Gold Plus H1951-028 (HMO) hearing services are covered with no deductible and no coinsurance, featuring a $35 copay for Medicare-covered exams, no copay for annual routine exams, and a $699 to $999 copay for up to two prescription hearing aids per year. This benefit is partially covered as over-the-counter (OTC) hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Humana Gold Plus H1951-028 (HMO) partially covers vision services with no copay and no coinsurance, although prior authorization is required. Covered benefits include one routine eye exam and up to $300 annually for contact lenses or eyeglasses (lenses and frames), while other eye exam services, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-028 (HMO) offers partially covered dental services up to a $3,000 annual maximum, with Medicare-covered dental requiring a $35 copay and no coinsurance. Most other covered services have no copay and no coinsurance, except for prosthodontics which require a 30% coinsurance and no copay, while fluoride, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus H1951-028 (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Humana Gold Plus H1951-028 (HMO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus H1951-028 (HMO) covers durable medical equipment (DME), prosthetics, and medical supplies with a 20% coinsurance and no copay, subject to prior authorization. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay from specified manufacturers, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-028 (HMO) covers diagnostic services with no coinsurance, offering no copay for lab services and a $0 to $50 copay for diagnostic procedures. Radiological services are also covered, featuring no copay for outpatient X-rays and diagnostic radiology, while therapeutic radiological services require a minimum 20% coinsurance and a $35 copay.
Home Health Services See details
Humana Gold Plus H1951-028 (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Humana Gold Plus H1951-028 (HMO) plan require prior authorization and feature no coinsurance, though only some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. For covered rehabilitation services, members will pay a $15 copay and no coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H1951-028 (HMO) with no coinsurance, requiring prior authorization but no 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 100-day Medicare benefit period are not covered.
Other Services See details
Humana Gold Plus H1951-028 (HMO) partially covers other services, offering acupuncture with a $35 copay and no coinsurance for up to 20 treatments per year, and chronic illness meal benefits with no copay or coinsurance. Prior authorization is required for these covered services, while over-the-counter (OTC) items are not covered.
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