Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP)

Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Southwest Virginia. The overall rating for this plan is not yet available for 2026.

It's important to know that Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP) 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 SNP-DE H2875-004 (HMO 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.

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:

Drug Coverage

The Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a standard pharmacy or preferred mail-order service. Standard mail-order options for generic drugs require a copay ranging from $10 to $30 for Tier 1 and $20 to $60 for Tier 2. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate remains the same whether you use a standard pharmacy, preferred mail order, or standard mail order. Knowing these specific tier costs helps you estimate your annual out-of-pocket prescription expenses with this Humana HMO D-SNP plan.

Additional Benefits

The Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP) plan provides comprehensive medical coverage with a mix of set copays and coinsurance for essential health services. Primary care visits require no copay with a 20% coinsurance, while specialist visits and outpatient hospital services generally incur a $45 copay. For inpatient hospital stays, members pay a flat copay of $2,080 or $2,230 per stay with no coinsurance, while emergency care has a $115 copay that is waived upon admission. This plan also features robust supplemental benefits designed to reduce out-of-pocket costs, including no copay and no coinsurance for routine preventive care, home health services, and up to 60 one-way transportation trips per year. Additionally, members can access routine dental, vision, and hearing care with no copay or coinsurance, including up to a $400 annual limit for eyewear and a $6,000 annual limit for covered dental services. Over-the-counter items and chronic illness meals are also provided with no copay or coinsurance.