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Humana Gold Plus H1951-048 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-048 (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 H1951-048 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-048 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Baton Rouge Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-048 (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 H1951-048 (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 H1951-048 (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 $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 $3850.00 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 H1951-048 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, beneficiaries enjoy no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic medications cost a low $5 copay for a 1-month supply at standard pharmacies, with no copay required for a 3-month supply ordered through preferred mail delivery. For Tier 3 preferred brand drugs, the plan requires a $47 copay for a 1-month supply, though a 3-month supply through preferred mail order offers a reduced cost of $131. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 47% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance. This clear cost-sharing structure helps you easily estimate your potential out-of-pocket prescription costs.
Additional Benefits
The Humana Gold Plus H1951-048 (HMO) plan offers comprehensive coverage with no copay for primary care visits, annual physicals, and home health services. Specialist visits require a $30 copay, while inpatient hospital stays carry an $85 daily copay for the first 11 days and no copay for days 12 through 90. Emergency room visits require a $150 copay, which is waived if you are admitted to the hospital within 24 hours. For specialty care, the plan features a $2,500 annual dental limit with no copay for preventive services, alongside no copay for routine eye and hearing exams. Covered eyewear is available with no copay up to a $300 yearly limit, while hearing aids require copays between $399 and $699. Additionally, diagnostic lab tests and outpatient x-rays require no copay, though dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H1951-048 (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring an $85 daily copay for days 1 through 11 and no copay for days 12 through 90. Additional acute care days are unlimited with no copay, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H1951-048 (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services range from no copay to a $155 copay, while observation services cost $85 per stay and outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Humana Gold Plus H1951-048 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-048 (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 to health-related locations are not covered under this plan.
Emergency Services See details
Humana Gold Plus H1951-048 (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 with no coinsurance, while worldwide emergency, urgent care, and emergency transportation are covered with a $150 copay and no coinsurance.
Primary Care See details
Primary care and professional services under the Humana Gold Plus H1951-048 (HMO) plan are covered with no copay and no coinsurance for primary care provider visits, while specialist visits require a $30 copay with no coinsurance. Physical, occupational, and speech therapies require a $25 copay, mental health services require a $35 copay, and telehealth options range from no copay to a $65 copay, all with no coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Humana Gold Plus H1951-048 (HMO) with no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, and diabetes self-management. Additional preventive services are partially covered, as fitness and in-home support are covered with no copay, but health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, massages, 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
Hearing services are covered by Humana Gold Plus H1951-048 (HMO) with no coinsurance, featuring a $30 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 for up to two devices per year, though inner ear, outer ear, over the ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Humana Gold Plus H1951-048 (HMO) provides partially covered vision services with no deductibles or coinsurance, which includes one routine eye exam annually with no copay, though other eye exams are not covered. Covered eyewear features one pair of contact lenses or eyeglasses (lenses and frames) per year with no copay up to a $300 limit, while individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-048 (HMO) offers partially covered dental services up to a $2,500 annual maximum, featuring no copay and no coinsurance for preventive, diagnostic, endodontic, periodontic, and oral surgery services. Restorative and prosthodontic services are covered with no copay and 30% to 40% coinsurance, while Medicare-covered dental has a $30 copay and no coinsurance. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H1951-048 (HMO) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
The Humana Gold Plus H1951-048 (HMO) plan covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Humana Gold Plus H1951-048 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic equipment and supplies are also covered, featuring a 10% to 20% coinsurance and copays ranging from no copay up to $10.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-048 (HMO) covers diagnostic and radiological services, with prior authorization required. Diagnostic procedures and tests carry a $0 to $65 copay with no coinsurance, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum $30 copay and 20% coinsurance.
Home Health Services See details
Humana Gold Plus H1951-048 (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Humana Gold Plus H1951-048 (HMO) plan with no coinsurance, though prior authorization is required. While some services are covered, specific options such as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a $20 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Humana Gold Plus H1951-048 (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H1951-048 (HMO) partially covers other services, offering acupuncture with a $30 copay and no coinsurance for up to 20 treatments per year, alongside a chronic illness meal benefit with no copay and no coinsurance. Prior authorization is required for these covered services, while over-the-counter (OTC) items are not covered by the plan.
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