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Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in New York. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus SNP-DE H3533-002 (HMO 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 Gold Plus SNP-DE H3533-002 (HMO 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 Gold Plus SNP-DE H3533-002 (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.
For Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP), 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 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 $9250.00 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 SNP-DE H3533-002 (HMO D-SNP) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when using standard pharmacies or preferred mail order for both 1-month and 3-month supplies. However, utilizing standard mail order for these generic tiers results in a copay of $10 to $20 for a 1-month supply and $30 to $60 for a 3-month supply. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% cost-sharing rate applies to standard pharmacies, preferred mail order, and standard mail order services alike. Specialty tier medications are limited to a 1-month supply at this same coinsurance rate.
Additional Benefits
The Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) offers comprehensive medical coverage with varying cost-sharing structures depending on the care you receive. Inpatient hospital stays require a copay of $2,230 for acute care or $2,080 for psychiatric care per stay, while emergency services carry a $115 copay. For outpatient and primary care, members generally face no copay and a 20% coinsurance, whereas preventive care and home health services are covered with no copay and no coinsurance. This plan also includes essential supplemental benefits such as dental, vision, and hearing services, many of which feature no copay. Routine eye exams, preventive dental, and hearing exams are available with no copay, and the plan covers up to two hearing aids every three years and up to $250 yearly for eyewear. Additionally, skilled nursing facility stays have no copay for the first 20 days, and members can access over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP), although upgrades and non-Medicare-covered stays are not covered. Acute stays require a $2,230 copay per stay with no coinsurance, while psychiatric stays carry a $2,080 copay per stay with no coinsurance.
Outpatient Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers outpatient hospital services with a $0 to $250 copay and 20% coinsurance, and ambulatory surgical center services with no copay and no coinsurance. Outpatient substance abuse and blood services are also covered with no copay and 20% coinsurance, though prior authorization is required.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Primary care and specialty services under the Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) are generally covered with no copay and a 20% coinsurance, while telehealth benefits require a copay of $0.00 to $40.00 and a 20% coinsurance. These benefits are partially covered, as podiatry services, routine chiropractic care, and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. However, additional preventive services are only partially covered, with exclusions for health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers hearing exams with no copay and either no coinsurance or a 20% coinsurance for routine annual visits. Prescription hearing aids are partially covered with no copay or coinsurance for up to two aids every three years, but inner ear, outer ear, and over the ear hearing aids are not covered. Unlimited over-the-counter hearing aids are also covered with no copay or coinsurance.
Vision Services See details
Vision Services are partially covered by Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP), featuring one annual routine eye exam with no copay, 20% coinsurance, and no deductible. Eyewear is also partially covered up to a $250 yearly limit with no copay for eyeglasses (lenses and frames) and no copay with a 20% coinsurance for contact lenses, while other eye exams, separate eyeglass lenses, separate frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) offers partially covered dental services, with Medicare-covered dental requiring no copay and a 20% coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance. Sub-services that are not covered under this plan include other preventive dental services, periodontics, maxillofacial prosthetics, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers Home Infusion bundled Services, subject to prior authorization and step therapy. Covered Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy and other Part B drugs carry a 0% to 20% coinsurance, with other Part B drugs having no copay.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with prior authorization. Most covered equipment and supplies require a 20% coinsurance and no copay, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers diagnostic and radiological services subject to a 20% coinsurance and prior authorization. Outpatient lab and X-ray services have no copay, while diagnostic procedures and tests have a copay ranging from $0 to $40.
Home Health Services See details
Home health services are covered by Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) with no copay and no coinsurance. Prior authorization is required to access these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) with no copay and require prior authorization, though only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) offers coverage for select other services, including acupuncture with no copay and 20% coinsurance for up to 20 treatments per year. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for acupuncture and meals, and some other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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