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Humana Gold Plus H2463-001 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H2463-001 (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 H2463-001 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H2463-001 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Pinal and Yuma Counties. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H2463-001 (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 H2463-001 (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 H2463-001 (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.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5150.00 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 H2463-001 (HMO) Medicare plan features an enhanced alternative drug benefit with no prescription drug deductible. For a 30-day supply, Tier 1 preferred generic drugs have no copay at standard pharmacies and through preferred mail order, while standard mail delivery has a $20 copay. Tier 2 standard generic drugs cost a $30 copay at standard pharmacies and preferred mail, or a $47 copay through standard mail. Tier 3 preferred brand drugs require a 35% coinsurance, and Tier 4 non-preferred drugs have a 33% coinsurance across standard pharmacies and mail options. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for covered Part D drugs.
Additional Benefits
The Humana Gold Plus H2463-001 (HMO) plan offers robust medical coverage with no copay for primary care visits and essential preventive services, while specialist visits require a $30 copay. For hospital care, inpatient stays carry a $360 daily copay for the first five days with no copay thereafter, and outpatient services range from no copay up to a $360 copay. Emergency care is accessible with a $130 copay, which is waived upon hospital admission, and urgent care requires a $50 copay. Supplemental benefits include dental coverage up to a $2,000 annual limit with no copay for most services, alongside routine vision and hearing exams that also feature no copay. Prescription hearing aids require copays ranging from $299 to $899, while durable medical equipment is covered with a 15% coinsurance and no copay. Additionally, home health services, over-the-counter items, and meal benefits are all covered with no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Humana Gold Plus H2463-001 (HMO) with no coinsurance, requiring a daily copay of $360 for days 1 to 5 of acute stays (no copay for days 6 to 999) and $325 for days 1 to 5 of psychiatric stays (no copay for days 6 to 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus H2463-001 (HMO) with no coinsurance. Patients will pay no copay for ambulatory surgical center and blood services, $25 to $35 for outpatient substance abuse sessions, and up to $360 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Humana Gold Plus H2463-001 (HMO) with a $35 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Humana Gold Plus H2463-001 (HMO) covers ground ambulance services with a $335 copay and air ambulance services with a $1250 copay, both with no coinsurance, while transportation services are not covered.
Emergency Services See details
Humana Gold Plus H2463-001 (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency coverage, urgent coverage, and emergency transportation are all covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H2463-001 (HMO) covers primary care physician services with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy visits require a $30 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, as routine chiropractic care is not covered. Additional covered services, including mental health, podiatry, and telehealth, feature copays ranging from $0 to $50 and no coinsurance.
Preventive Services See details
Humana Gold Plus H2463-001 (HMO) covers essential preventive services, including annual physical exams, glaucoma screenings, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are only partially covered, as the plan excludes services such as health education, weight management programs, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H2463-001 (HMO), with no coinsurance required for any services. There is no copay for routine annual hearing exams, fitting evaluations, and OTC hearing aids, though Medicare-covered exams have a $30 copay, and covered prescription hearing aids require a $299 to $899 copay while inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Humana Gold Plus H2463-001 (HMO) partially covers Vision Services with no deductible and no coinsurance. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) feature no copay, although other eye exams may carry a copay of $0 to $30, and eyewear has a $150 annual limit. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H2463-001 (HMO) offers partially covered dental services up to a $2,000 annual maximum, with fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics excluded from coverage. Medicare-covered dental services require a $30 copay and no coinsurance, prosthodontics require a 30% coinsurance and no copay, and all other covered services require no copay and no coinsurance.
Home Infusion bundled Services See details
Humana Gold Plus H2463-001 (HMO) covers home infusion bundled services, including Medicare Part B chemotherapy, radiation, and other drugs with no copay and no coinsurance to 20% coinsurance. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H2463-001 (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H2463-001 (HMO) covers medical equipment with prior authorization, including durable medical equipment (DME) for a 15% coinsurance and no copay. Prosthetics and medical supplies require a 15% to 20% coinsurance and no copay, while diabetic supplies have a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H2463-001 (HMO) covers diagnostic and radiological services with prior authorization required. Lab and outpatient X-ray services have no copay and no coinsurance, diagnostic procedures carry a $0 to $100 copay with no coinsurance, diagnostic radiology has a $0 to $300 copay with no coinsurance, and therapeutic radiology requires a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H2463-001 (HMO) with no copay and no coinsurance. Prior authorization is required to receive these home health benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Humana Gold Plus H2463-001 (HMO) where some services are covered, but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H2463-001 (HMO) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization with a daily copay of $10 for days 1 to 20, a daily copay of $218 for days 21 to 100, and no coinsurance. Additional days beyond Medicare-covered SNF services are not covered.
Other Services See details
Humana Gold Plus H2463-001 (HMO) partially covers other services, offering acupuncture for a $30 copay and no coinsurance, alongside over-the-counter items and meal benefits with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
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