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Humana Gold Plus H1951-059 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H1951-059 (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 H1951-059 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H1951-059 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in New Orleans Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H1951-059 (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 H1951-059 (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 H1951-059 (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
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 $3250.00 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 H1951-059 (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 1-month and 3-month supplies at standard retail pharmacies or through preferred mail order. If you choose standard mail order, Tier 1 drugs have a $10 copay and Tier 2 drugs have a $20 copay for a 1-month supply. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply at standard pharmacies and mail-order services, though a 3-month supply is slightly cheaper at $131 through preferred mail order. Higher-tier medications are subject to coinsurance rather than flat copays. Tier 4 non-preferred drugs require 50% coinsurance, while Tier 5 specialty drugs require 25% coinsurance for a 1-month supply.
Additional Benefits
The Humana Gold Plus H1951-059 (HMO) plan offers robust coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $20 copay, while inpatient hospital stays cost a $70 daily copay for the first 10 days and no copay for days 11 through 90. Outpatient hospital services feature no coinsurance and a copay ranging from no copay to $120 depending on the service. This plan also includes valuable dental, vision, and hearing benefits with no deductibles and no coinsurance for routine services. Dental care is covered with no copay up to a $4,000 annual maximum, routine vision exams and eyewear are covered up to a $250 limit with no copay, and routine hearing exams feature no copay. Additionally, members can access up to 60 free one-way transportation trips per year to plan-approved locations with no copay.
Inpatient Hospital See details
Humana Gold Plus H1951-059 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $70 daily copay for days 1 to 10 and no copay for days 11 to 90 per stay. Unlimited additional acute care days are covered with no copay, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H1951-059 (HMO) outpatient services are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services have a copay of $0 to $120, outpatient observation services cost a $70 copay per stay, and outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Humana Gold Plus H1951-059 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H1951-059 (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 or coinsurance for up to 60 one-way trips per year to plan-approved locations, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by Humana Gold Plus H1951-059 (HMO) with a $150 copay and no coinsurance, and the copay is 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, and transportation services are covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H1951-059 (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 therapy services carry a $25 copay, mental health and psychiatric services require a $35 copay, and telehealth ranges from no copay to a $65 copay, all with no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H1951-059 (HMO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered, featuring fitness and in-home support services, while sub-services such as health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Humana Gold Plus H1951-059 (HMO) covers hearing services with no deductible, offering Medicare-covered exams for a $20 copay and no coinsurance, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus H1951-059 (HMO), featuring no deductible, no coinsurance, copays ranging from $0 to $20 for eye exams, and no copay for covered eyewear up to a $250 annual limit. While routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered, other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H1951-059 (HMO) partially covers dental services, offering Medicare-covered dental with a $20 copay and no coinsurance, and other covered dental services with no copay and no coinsurance up to a $4,000 annual maximum. While many preventive and comprehensive services are covered, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H1951-059 (HMO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H1951-059 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Humana Gold Plus H1951-059 (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 and no coinsurance.
Diagnostic and Radiological Services See details
Humana Gold Plus H1951-059 (HMO) covers diagnostic and radiological services with prior authorization required. Lab and outpatient X-ray services feature no copay, diagnostic tests range from a $0 to $65 copay with no coinsurance, and therapeutic radiological services require a minimum $20 copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H1951-059 (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the Humana Gold Plus H1951-059 (HMO) plan, as all sub-services—including intensive cardiac, pulmonary, and SET for PAD—are listed as not covered with a $20 copay, despite the benefit technically having no coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H1951-059 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H1951-059 (HMO) provides partial coverage for other services, including acupuncture with a $20 copay and no coinsurance for up to 20 treatments per year, and a chronic illness meal benefit with no copay and no coinsurance. Both covered services require prior authorization, while over-the-counter (OTC) items are not covered.
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