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Humana Gold Plus H1951-052 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-052 (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 H1951-052 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-052 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Central Louisiana. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-052 (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 H1951-052 (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 H1951-052 (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 $3.00. 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 $590.00 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 $4800.00 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 H1951-052 (HMO) plan features an annual prescription drug deductible of $590. For Tier 1 preferred generic drugs, you will enjoy no copay for a 1-month or 3-month supply at standard pharmacies and preferred mail-order services. Tier 2 generic medications are also highly affordable, with standard pharmacy copays starting at $5 and no copay for a 3-month supply filled through preferred mail order. For brand-name and specialty medications, costs vary depending on the drug tier and coverage phase. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, while Tier 4 non-preferred drugs carry a 50% coinsurance. Specialty medications in Tier 5 require a 26% coinsurance for a 1-month supply across all standard and mail-order options.
Additional Benefits
The Humana Gold Plus H1951-052 (HMO) plan offers comprehensive medical coverage with no copay for primary care doctor visits and a $25 copay for specialist visits. Preventive services and home health care are covered with no copay or coinsurance, while emergency room visits require a $130 copay. For inpatient hospital stays, members pay a $230 daily copay for days 1 through 10, and no copay for days 11 through 90. This plan also features supplemental benefits, including routine dental and vision exams with no copay, a $2,000 annual limit for dental services, and a $300 annual limit for eyewear. Hearing care includes routine exams with no copay and prescription hearing aids with copays between $599 and $899. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Gold Plus H1951-052 (HMO) with no coinsurance, requiring a $230 daily copay for days 1 through 10 and no copay for days 11 through 90. Unlimited additional acute care days are covered with no copay, though additional psychiatric stays, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H1951-052 (HMO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services have a copay of $0 to $190, observation services cost a $230 copay per stay, and outpatient substance abuse sessions require a $35 copay, with prior authorization required for most services.
Partial Hospitalization See details
Humana Gold Plus H1951-052 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-052 (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. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Humana Gold Plus H1951-052 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are available with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Primary care services under Humana Gold Plus H1951-052 (HMO) feature no copay and no coinsurance for primary care doctor visits, while specialist visits require a $25 copay and no coinsurance. Therapy services, including physical, occupational, and speech, have a $24 copay and no coinsurance, while mental health, psychiatric, and opioid treatment sessions require a $35 copay and no coinsurance. Podiatry is not covered, and although some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus H1951-052 (HMO) covers preventive services with no copay and no coinsurance, though prior authorization is required for some benefits. This coverage is only partially covered, as excluded services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, caregiver support, supplemental smoking cessation, disease management, telemonitoring, remote access technologies, bathroom safety devices, and counseling.
Hearing Services See details
Humana Gold Plus H1951-052 (HMO) hearing services are partially covered, offering Medicare-covered exams for a $25 copay and no coinsurance, alongside routine exams and fitting evaluations for no copay and no coinsurance. Prescription hearing aids are covered for up to two devices per year with no coinsurance and copays ranging from $599.00 to $899.00, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus H1951-052 (HMO) with no coinsurance, featuring a $0 to $25 copay for eye exams and no copay for covered eyewear up to a $300 annual limit. While routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered, other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-052 (HMO) partially covers dental services, featuring a $25 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered preventive and comprehensive services up to a $2,000 annual limit. Fluoride treatments, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus H1951-052 (HMO) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, are covered with a 0% to 20% coinsurance, with insulin also requiring a $35.00 copay.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H1951-052 (HMO) with no copay and a 20% coinsurance, subject to prior authorization.
Medical Equipment See details
Humana Gold Plus H1951-052 (HMO) covers durable medical equipment, 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 require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-052 (HMO) covers diagnostic and radiological services with prior authorization required. Lab services require no copay and no coinsurance, diagnostic procedures have a $0 to $50 copay and no coinsurance, and therapeutic radiological services require a minimum $25 copay and 20% minimum coinsurance.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H1951-052 (HMO) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Humana Gold Plus H1951-052 (HMO) covers Cardiac Rehabilitation Services with a $15 copay and no coinsurance, subject to prior authorization. While some services are covered, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H1951-052 (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, a three-day prior hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Humana Gold Plus H1951-052 (HMO) provides partially covered other services, featuring acupuncture for a $25 copay and no coinsurance up to 20 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Both of these services require prior authorization, while over-the-counter (OTC) items are not covered.
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