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Humana Gold Plus H1951-049 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-049 (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 H1951-049 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-049 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Louisiana Parishes. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-049 (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 H1951-049 (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 H1951-049 (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 $6650.00 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 H1951-049 (HMO) plan features an annual drug deductible of $615 and offers budget-friendly coverage for generic medications. For Tier 1 preferred generics, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic medications are also highly accessible, costing a $5 copay for a 1-month supply, or no copay for a 3-month supply when using preferred mail order. For brand-name and higher-tier medications, costs are structured as copays or coinsurance. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across standard pharmacies and mail-order options. Meanwhile, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require 25% coinsurance for a 1-month supply across all standard and preferred networks.
Additional Benefits
The Humana Gold Plus H1951-049 (HMO) plan offers comprehensive medical coverage with no copays for primary care visits, annual physicals, and routine home health services. Specialist visits require a $25 copay, while inpatient hospital stays incur a daily copay of $225 for the first 10 days of acute care. Emergency room visits are covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features valuable supplemental benefits, including routine dental care covered with no copay up to a $1,250 annual maximum, and a $250 annual allowance for eyeglasses or contacts with no copay. Routine hearing exams have no copay, and prescription hearing aids are available with copays ranging from $299 to $599. Additionally, skilled nursing facility stays have no copay for the first 20 days, while durable medical equipment is covered with a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H1951-049 (HMO) covers inpatient hospital services with no coinsurance, requiring a $225 daily copay for days 1 to 10 of acute stays and a $220 daily copay for days 1 to 10 of psychiatric stays, with no copay thereafter. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H1951-049 (HMO) outpatient services are covered with no coinsurance, featuring a $0 to $275 copay for outpatient hospital services and a $225 copay per stay for observation services. Substance abuse outpatient sessions require a $35 copay, while ambulatory surgical center and blood services are covered with no copay.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H1951-049 (HMO) with a $35 copay and no coinsurance. Prior authorization is required for this service.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-049 (HMO) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Humana Gold Plus H1951-049 (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are all covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-049 (HMO) features primary care physician visits with no copay and no coinsurance, alongside specialist visits for a $25 copay and no coinsurance. Physical, speech, and occupational therapies require a $20 copay and no coinsurance, mental health and psychiatric services have a $35 copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H1951-049 (HMO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered with no copay or coinsurance (prior authorization required), but do not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Gold Plus H1951-049 (HMO) partially covers hearing services with no deductible, offering Medicare-covered exams for a $25 copay, and routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with a copay of $299 to $599 and no coinsurance, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Humana Gold Plus H1951-049 (HMO) offers partially covered vision services with no copay, no coinsurance, and no deductible for covered benefits, which include one routine eye exam and up to $250 annually for one pair of eyeglasses or contact lenses. Other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-049 (HMO) features dental services with a $25 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other preventive and comprehensive dental services up to a $1,250 annual maximum. This benefit is partially covered, as fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H1951-049 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H1951-049 (HMO) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Gold Plus H1951-049 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-049 (HMO) covers diagnostic and radiological services, featuring no coinsurance for diagnostic services, which include lab tests at no copay and diagnostic procedures with a $0 to $50 copay. Radiological services require prior authorization, offering outpatient X-rays at no copay, diagnostic radiology starting at a $0 copay, and therapeutic radiology with a minimum $25 copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H1951-049 (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-049 (HMO) covers some cardiac rehabilitation services with no coinsurance and a $15 copay, requiring prior authorization. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H1951-049 (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, followed by 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 H1951-049 (HMO) partially covers other services, offering acupuncture with a $25 copay and no coinsurance for up to 20 treatments annually, and a chronic illness meal benefit with no copay and no coinsurance. Both covered benefits require prior authorization, while over-the-counter (OTC) items are not covered.
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