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Humana Gold Plus H1951-047 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-047 (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 H1951-047 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-047 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in New Orleans Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-047 (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 H1951-047 (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 H1951-047 (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 $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 $350.00 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 $3700.00 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 H1951-047 (HMO) prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies and through preferred mail order services. Tier 2 generic drugs are also highly affordable, costing as little as a $5 copay for a one-month supply at standard pharmacies, or no copay for a three-month supply via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply across standard pharmacies and mail order options. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 43% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance. Understanding these tier-based copays and coinsurance rates helps you accurately estimate your yearly out-of-pocket prescription costs with this Humana HMO plan.
Additional Benefits
The Humana Gold Plus H1951-047 (HMO) plan offers affordable medical coverage with no copay for primary care visits, preventive services, and home health care. Specialist visits require a $30 copay, while inpatient hospital stays cost a daily copay of $85 for the first 10 days and no copay for days 11 to 90. Emergency room visits have a $150 copay, which is waived if you are admitted, and urgent care visits carry a $65 copay. This plan also includes robust dental, vision, and hearing benefits, featuring no copay for routine dental services up to a $2,500 annual limit and no copay for eyewear up to a $300 yearly limit. Routine hearing exams require no copay, and prescription hearing aids are covered with copays ranging from $399 to $699. For recovery and medical equipment, skilled nursing facilities offer no copay for the first 20 days, while durable medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H1951-047 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $85 for days 1 to 10 and no copay for days 11 to 90 for acute and psychiatric stays. Unlimited additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H1951-047 (HMO) covers outpatient services with no coinsurance, featuring a copay of no copay to $155 for outpatient hospital services and $85 per stay for observation services. Ambulatory surgical center and blood services have no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H1951-047 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-047 (HMO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H1951-047 (HMO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-047 (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Physical and occupational therapy require a $25 copay, mental health services have a $35 copay, and telehealth costs between a $0 and $65 copay, all with no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H1951-047 (HMO) covers preventive services with no copay and no coinsurance, including annual exams, kidney disease education, and select screenings. Additional benefits are partially covered, but health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H1951-047 (HMO) with no coinsurance, offering routine exams and fitting evaluations with no copay, and Medicare-covered exams for a $30 copay. Up to two prescription hearing aids per year are covered with a $399 to $699 copay and no coinsurance, but OTC hearing aids and inner-ear, outer-ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Humana Gold Plus H1951-047 (HMO) offers partial vision coverage with no deductibles and no coinsurance, though prior authorization is required. Eye exams have a $0 to $30 copay, and contact lenses or eyeglasses are covered with no copay up to a $300 annual limit, but other eye exams, individual lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H1951-047 (HMO), featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other diagnostic, preventive, and comprehensive services up to a $2,500 annual limit. Fluoride treatments, implants, maxillofacial prosthetics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Humana Gold Plus H1951-047 (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while covered Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H1951-047 (HMO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus H1951-047 (HMO), with durable medical equipment, prosthetics, and medical supplies requiring a 20% coinsurance and no copay. Diabetic supplies feature a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-047 (HMO) covers diagnostic and radiological services with no coinsurance for diagnostic tests, and no copay for lab services and outpatient X-rays. Diagnostic procedures have a copay ranging up to $65, while therapeutic radiological services require a minimum 20% coinsurance and a minimum $30 copay.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H1951-047 (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-047 (HMO) does not cover cardiac rehabilitation services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H1951-047 (HMO) 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, but a prior three-day inpatient hospital stay is not, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other services covered under the Humana Gold Plus H1951-047 (HMO) include up to 20 acupuncture visits per year for a $30 copay and no coinsurance, as well as chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for these benefits, and over-the-counter (OTC) items are not covered.
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