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Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Virginia. The overall rating for this plan is not yet available for 2025.
It's important to know that Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP).
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 Dual Fully Integrated H2875-001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.70. 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 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 $9350.00 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 Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. If you qualify for the low-income subsidy (LIS), your monthly Part D premium is $30.70. During the initial coverage phase, after the deductible is met, you will pay the costs for your drugs until your total drug costs reach $2000.00. Once your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for covered drugs.
Additional Benefits
The Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan provides a range of benefits with varying costs. It covers inpatient hospital stays with copays, and outpatient services and primary care with coinsurance. Many services, like preventive care, vision exams, and dental services, have no copay. The plan also includes coverage for ambulance services with a copay, and emergency services with a copay or coinsurance, depending on the service. Additionally, it offers home health services, hearing services, and medical equipment with varying cost-sharing arrangements. Some services, such as skilled nursing facilities and home infusion services, require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is a copay of $2185.00 per admission or stay, and for Inpatient Hospital Psychiatric, there is a copay of $2036.00 per admission or stay. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services. Outpatient Hospital Services and Observation Services have a 20% coinsurance, while Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services have a minimum and maximum 20% coinsurance. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the plan, but requires Prior Authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a $315 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, and Urgently Needed Services have 20% coinsurance, while Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay.
Primary Care See details
The Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan covers primary care services with a 20% coinsurance. Chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, psychiatric services, physical therapy and speech-language pathology services, and opioid treatment program services are covered with a 20% coinsurance. Additional telehealth benefits have a 20% coinsurance and no copay. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, Annual Physical Exams with no copay, and additional preventive services. Other preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, have no copay.
Hearing Services See details
The Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with no copay for all types, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with no copay and 20% coinsurance. Eyewear benefits are covered with no copay, and the plan covers a combined maximum of $450 for all eyewear every year; contact lenses and eyeglasses (lenses and frames) are covered with no copay, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services with a maximum plan benefit of $4,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, and other Medicare Part B Drugs have a coinsurance between 0% and 20% with no copay. Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan and require prior authorization. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and no copay. Diabetic Supplies have a 20% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
The Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan covers Diagnostic and Radiological Services. Diagnostic Procedures/Tests have a coinsurance of at most 20%, and Lab Services have a coinsurance of at most 20% with no copay. Diagnostic Radiological Services have a coinsurance of at most 20% and a copay of at most $325, and Outpatient X-Ray Services have a coinsurance of at most 20% and a $50 copay.
Home Health Services See details
Home Health Services are covered by the Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the listed sub-services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP) plan covers acupuncture with a 20% coinsurance, and a limit of 20 treatments per year. Over-the-counter (OTC) items are covered, with a maximum benefit of $2700 per year, and the plan offers nicotine replacement therapy. Meal benefits are covered with no copay. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services.
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