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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 $20.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $4150.00 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies or through preferred mail order. Tier 2 generic medications cost as little as a $5 copay for a 1-month supply, and you can secure a 3-month supply with no copay when using preferred mail order. For Tier 3 preferred brand drugs, the plan features a $47 copay for a 1-month supply, with a reduced $131 copay for a 3-month supply through preferred mail order. More expensive medications transition to coinsurance, with Tier 4 non-preferred drugs requiring a 47% coinsurance and Tier 5 specialty drugs carrying a 25% coinsurance.
Additional Benefits
The Humana Gold Plus H1951-048 (HMO) plan offers robust medical coverage featuring no copay for primary care visits, preventive services, and home health care. Inpatient hospital stays require a $169 daily copay for the first 10 days and no copay for days 11 through 90, while specialist visits require a $35 copay and outpatient hospital services range from no copay to a $125 copay. Emergency room visits carry a $150 copay, and ground ambulance services require a $335 copay, both with no coinsurance. Additionally, this plan covers up to 60 one-way transportation trips per year and up to $2,500 in dental services with no copay for covered routine care. Vision benefits include a $300 annual allowance for eyewear with no copay, and prescription hearing aids are covered with a copay of $699 to $999. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H1951-048 (HMO) covers inpatient hospital services with no coinsurance, requiring a $169 daily copay for days 1 to 10 and no copay for days 11 to 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric 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 a $0 to $125 copay for outpatient hospital services and a $169 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H1951-048 (HMO) with a $35.00 copay and no coinsurance, though prior authorization is required.
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. Transportation services are partially covered with no copay and no coinsurance for up to 60 one-way trips per year to plan-approved locations, though transportation to other health-related locations is not covered.
Emergency Services See details
Humana Gold Plus H1951-048 (HMO) emergency services are covered with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services each carry a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-048 (HMO) features primary care physician visits with no copay and no coinsurance, alongside specialist and mental health services for a $35 copay and no coinsurance. Physical and occupational therapies require a $25 copay with no coinsurance, telehealth services range from a $0 to $65 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H1951-048 (HMO) preventive services are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, fitness benefits, and diabetes self-management training. However, additional supplemental preventive benefits are only partially covered, with services such as health education, medical nutrition therapy, and personal emergency response systems not covered under this plan.
Hearing Services See details
Humana Gold Plus H1951-048 (HMO) partially covers hearing services, offering routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are covered with a copay ranging from $699 to $999 and no coinsurance for up to two devices per year, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Humana Gold Plus H1951-048 (HMO) partially covers vision services with no coinsurance, featuring a $0 to $35 copay for eye exams and no copay for eyewear up to a $300 annual limit. Prior authorization is required, and other eye exam services, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H1951-048 (HMO), featuring a $35 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,500 annual maximum. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered, and prior authorization is required for certain services.
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. Medicare Part B chemotherapy, radiation, and other drugs require no copay and between no coinsurance and 20% coinsurance, while Part B insulin drugs have a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H1951-048 (HMO) 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 supplies are covered with no copay and 10% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-048 (HMO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $65 copay for procedures, while radiological services range from no copay for X-rays and diagnostic radiology to a $35 copay and 20% minimum coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H1951-048 (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-048 (HMO) offers Cardiac Rehabilitation Services with no coinsurance and a $15 copay, where some services are covered but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H1951-048 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and 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 $35 copay and no coinsurance for up to 20 treatments per year, alongside a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered, and prior authorization is required for the covered services.
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