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Humana Gold Plus Giveback H3533-027 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Giveback H3533-027 (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 Giveback H3533-027 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus Giveback H3533-027 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in New York City and Long Island. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus Giveback H3533-027 (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 Giveback H3533-027 (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 Giveback H3533-027 (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. Additionally, this plan comes with a Part B Premium reduction of $61.00. 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 $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 Giveback H3533-027 (HMO) Medicare Advantage plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, costing as low as a $5 copay for a 1-month supply, or no copay for a 3-month supply when using preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a 1-month supply, or a reduced $131 copay for a 3-month supply through preferred mail order. Higher-tier medications are subject to coinsurance, with Tier 4 non-preferred drugs requiring 31% coinsurance and Tier 5 specialty drugs requiring 25% coinsurance. Choosing preferred mail order and standard pharmacies for your prescriptions helps maximize your savings under this plan.
Additional Benefits
The Humana Gold Plus Giveback H3533-027 (HMO) plan provides affordable healthcare coverage with no copays or coinsurance for primary care visits, telehealth, and preventive services. Specialist visits require a $40 copay, while inpatient acute hospital stays carry a $480 daily copay for the first five days followed by no copay for additional days. Emergency care is available with a $115 copay, which is waived if you are admitted, and urgent care services have a $40 copay. For everyday wellness, this plan features no copays for routine dental exams, cleanings, annual routine vision exams, and up to $200 annually for eyewear. Routine hearing exams and home health services are also covered with no copay, though prescription hearing aids require copays between $699 and $999. Additionally, diagnostic lab services and outpatient X-rays are covered with no copays, helping you keep out-of-pocket costs predictable.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Gold Plus Giveback H3533-027 (HMO) with no coinsurance, though prior authorization is required. You will pay a $480 copay for days 1 through 5 of an acute stay and a $410 copay for days 1 through 5 of a psychiatric stay, with no copay for subsequent covered days, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which also feature no copays. Outpatient hospital services require a copay between no copay and $850 (with a $480 copay per stay for observation services), while outpatient substance abuse individual and group sessions have a $35 copay.
Partial Hospitalization See details
Humana Gold Plus Giveback H3533-027 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the Humana Gold Plus Giveback H3533-027 (HMO) plan are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are available with 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
Humana Gold Plus Giveback H3533-027 (HMO) offers primary care physician visits and telehealth services with no copay and no coinsurance. Specialist visits require a $40 copay, while physical, occupational, speech, and mental health therapies have a $35 copay, all with no coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Humana Gold Plus Giveback H3533-027 (HMO) with no copay and no coinsurance for covered care, which includes annual physical exams, kidney disease education, memory fitness, and select screenings. Multiple supplemental benefits are not covered under this plan, such as health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, weight management programs, and counseling.
Hearing Services See details
Humana Gold Plus Giveback H3533-027 (HMO) partially covers hearing services with no deductibles, featuring Medicare-covered exams for a $40 copay and routine exams or fitting evaluations with no copay, all with no coinsurance. Up to two prescription hearing aids are covered annually with no coinsurance and copays ranging from $699 to $999, though 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 Giveback H3533-027 (HMO) with no deductible, no coinsurance, and no copay for one routine eye exam and eyewear (contact lenses or eyeglasses) up to a $200 yearly limit. Other eye exam services, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus Giveback H3533-027 (HMO) provides partially covered dental services, offering preventive care like cleanings, exams, and X-rays with no copay and no coinsurance, while Medicare-covered dental services require a $40 copay and no coinsurance. However, fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus Giveback H3533-027 (HMO), including durable medical equipment (DME) with no copay and 16% coinsurance, and prosthetics or medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay and 10% to 20% coinsurance, while diabetic therapeutic shoes or inserts carry a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $100, while lab services and outpatient X-rays feature no copays. Diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Humana Gold Plus Giveback H3533-027 (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Humana Gold Plus Giveback H3533-027 (HMO) with no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Giveback H3533-027 (HMO) 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 inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus Giveback H3533-027 (HMO) partially covers other services, offering acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, as well as chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit.
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