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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 $5900.00 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 plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, with a $5 copay for a 1-month supply at standard pharmacies and preferred mail order, and no copay for a 3-month supply filled via preferred mail order. For brand-name and specialty medications, costs are structured as copays or coinsurance depending on the tier. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply at standard pharmacies and through mail order. Tier 4 non-preferred drugs carry a 43% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply.
Additional Benefits
The Humana Gold Plus H1951-047 (HMO) plan offers robust medical coverage featuring no copay for primary care visits and routine preventive services, while specialist visits require a $25 copay. For hospital care, members pay a $95 daily copay for the first 10 days of inpatient stays, while outpatient surgical services require no copay. Emergency room visits carry a $130 copay, which is waived if admitted, and urgent care visits cost a $50 copay. Supplemental benefits include routine dental care with no copay up to a $3,000 annual maximum, alongside routine vision exams and select eyewear covered with no copay up to $300. Routine hearing exams also feature no copay, while prescription hearing aids require a copay between $399 and $999. Additionally, members benefit from no copay for home health services and up to 60 yearly one-way trips to plan-approved locations, with a 20% coinsurance for durable medical equipment.
Inpatient Hospital See details
Humana Gold Plus H1951-047 (HMO) covers inpatient hospital services with no coinsurance, requiring a $95 daily copay for days 1 through 10 and no copay for days 11 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional inpatient psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H1951-047 (HMO) covers outpatient services with no coinsurance, featuring a $0 to $135 copay for outpatient hospital services, a $95 copay per stay for observation services, and a $35 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copays and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H1951-047 (HMO) with a $35 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus H1951-047 (HMO), featuring a $335 copay and coinsurance for ground ambulance, and a 20% coinsurance and copay for air ambulance. Transportation is partially covered with no copay and no coinsurance for up to 60 yearly one-way trips to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus H1951-047 (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay 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 for a $130 copay each with no coinsurance.
Primary Care See details
Humana Gold Plus H1951-047 (HMO) features no copay and no coinsurance for primary care visits, while specialist visits require a $25 copay and therapy services cost $20, both with no coinsurance. Mental health, psychiatric, and opioid treatments carry a $35 copay with no coinsurance, whereas podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Humana Gold Plus H1951-047 (HMO) offers preventive services, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training, with no copay and no coinsurance. While fitness benefits and in-home support services are also covered with no copay, other supplemental benefits such as health education, nutritional therapy, and home safety modifications are not covered.
Hearing Services See details
Humana Gold Plus H1951-047 (HMO) covers hearing services, offering routine exams and fitting evaluations with no copay and no coinsurance, and Medicare-covered exams for a $25 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay between $399 and $999 for up to two aids per year, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus H1951-047 (HMO) with no copay, no coinsurance, and no deductible for one routine eye exam and select eyewear per year, up to a $300 limit. While contact lenses and complete eyeglasses (lenses and frames) are covered with no copay, other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-047 (HMO) dental services are partially covered, offering Medicare-covered dental services for a $25 copay and no coinsurance, and other covered services with no copay and no coinsurance up to a $3,000 yearly maximum. However, fluoride treatment, maxillofacial prosthetics, implant services, 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 and no coinsurance, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H1951-047 (HMO) plan with no copay and a 20% coinsurance, subject to prior authorization.
Medical Equipment See details
Humana Gold Plus H1951-047 (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, 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 have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Humana Gold Plus H1951-047 (HMO) with prior authorization required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $50 copay for tests, while radiological services feature no copay for X-rays and diagnostic radiology, and a minimum 20% coinsurance and $25 copay for therapeutic services.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H1951-047 (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-047 (HMO) covers Cardiac Rehabilitation Services with a $15 copay, no coinsurance, and prior authorization requirements. Some services are covered, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H1951-047 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Humana Gold Plus H1951-047 (HMO) partially covers other services, offering acupuncture with a $25 copay and no coinsurance for up to 20 treatments per year, as well as a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
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