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Humana Gold Plus H1951-058 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-058 (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 H1951-058 (HMO) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Humana Gold Plus H1951-058 (HMO) is a HMO plan offered by Humana Health Benefit Plan of Louisiana, Inc. available for the 2026 plan year 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 H1951-058 (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 H1951-058 (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 H1951-058 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.00. 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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $3250.00 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 H1951-058 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for a 1-month or 3-month supply at standard pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, you will pay a copay of $10 to $20 for a 1-month supply. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, though a 3-month supply via preferred mail order offers a reduced copay of $131. Higher-tier prescriptions are subject to coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance. This structure helps you estimate your out-of-pocket prescription costs based on your specific medication tiers.
Additional Benefits
The Humana Gold Plus H1951-058 (HMO) plan offers comprehensive medical coverage with no copay for primary care visits, routine physicals, and key preventive services. Specialist visits require a $20 copay, while inpatient hospital stays feature a $70 daily copay for the first 10 days followed by no copay for additional days. Emergency room visits carry a $150 copay, which is waived upon admission, and urgent care services require a $65 copay. Beyond standard care, this plan provides robust supplemental benefits including vision coverage up to a $300 yearly limit and dental services with no copay up to a $3,000 annual maximum. Members also benefit from routine hearing exams and up to 60 one-way transportation trips per year to plan-approved locations at no copay. Other essential services like home health visits and home infusions are fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Humana Gold Plus H1951-058 (HMO) inpatient hospital care is partially covered with no coinsurance, requiring a $70 daily copay for days 1 to 10 and no copay for days 11 to 90 (with unlimited additional acute care days at no copay). Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H1951-058 (HMO) outpatient services are covered with no coinsurance, including outpatient hospital visits with a $0 to $100 copay and observation services with a $70 copay per stay. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $35 copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H1951-058 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-058 (HMO) covers ground ambulance services with a $335 copay plus coinsurance, and air ambulance services with a 20% coinsurance plus a copay. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus H1951-058 (HMO) emergency services are covered with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $65 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-058 (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $20 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay with no coinsurance, mental health and psychiatric sessions require a $35 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H1951-058 (HMO) covers key preventive services, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes training, with no copays and no coinsurance. While fitness benefits and in-home support are covered with no copays and no coinsurance, other additional services, such as health education, in-home safety assessments, and nutritional therapy, are not covered.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H1951-058 (HMO), featuring Medicare-covered exams for a $20 copay and routine exams and fittings with no copay, all with no coinsurance. Prescription hearing aids are covered with copays ranging from $99 to $399 and no coinsurance, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H1951-058 (HMO) provides partial coverage for vision services with no deductible, no coinsurance, and no copays for one annual routine eye exam and select eyewear up to a $300 yearly limit. Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered, and prior authorization is required.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H1951-058 (HMO), with Medicare-covered dental services requiring a $20 copay and no coinsurance, and other covered dental services requiring no copay and no coinsurance up to a $3,000 annual maximum. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H1951-058 (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other drugs require no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H1951-058 (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Humana Gold Plus H1951-058 (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 and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-058 (HMO) covers diagnostic and radiological services with prior authorization, featuring diagnostic services with no coinsurance, no copay for lab services, and a $0 to $65 copay for diagnostic tests. Radiological services include outpatient X-rays and diagnostic radiology with no copay, while therapeutic radiology requires a minimum 20% coinsurance and a $20 copay.
Home Health Services See details
Humana Gold Plus H1951-058 (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 provided by Humana Gold Plus H1951-058 (HMO) with no coinsurance and required prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and carry a $20 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H1951-058 (HMO) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other services under the Humana Gold Plus H1951-058 (HMO) plan are partially covered, featuring acupuncture with a $20 copay and no coinsurance for up to 20 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for both of these covered services, while over-the-counter (OTC) items are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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