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Humana Gold Plus H3533-033 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H3533-033 (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 H3533-033 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H3533-033 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Brooklyn and Queens. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H3533-033 (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 H3533-033 (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 H3533-033 (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 $1.00. 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 $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 Gold Plus H3533-033 (HMO) plan has a $590 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, for preferred generic drugs, you will pay a $12 copay at preferred pharmacies and preferred mail order, and a $20 copay at standard mail order. For preferred brand drugs, you will pay 26% coinsurance at all pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Humana Gold Plus H3533-033 (HMO) plan offers comprehensive coverage, including inpatient hospital stays with varying copays, outpatient services, and emergency care with copays. This plan also includes coverage for primary care, preventive services, hearing, vision, and dental services, often with no copays for routine services. Additional benefits of this plan include ambulance and transportation services, home health, and skilled nursing facility care with specific copays and requirements. Other covered services include medical equipment, diagnostic and radiological services, and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $310 for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Inpatient Hospital Psychiatric has a copay of $305 for days 1-6 and no copay for days 7-90. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services for the Humana Gold Plus H3533-033 (HMO) plan include coverage for outpatient hospital services with a copay of $45.00 - $1400.00, observation services with a $310 copay, and ambulatory surgical center (ASC) services with a $445 copay. Outpatient substance abuse services have copays ranging from $40.00 to $85.00 for individual and group sessions, while outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H3533-033 (HMO) plan with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $315 copay. Transportation services to plan-approved health-related locations are covered with no copay, up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Humana Gold Plus H3533-033 (HMO) plan. Emergency Services have a $110 copay with no coinsurance, Urgently Needed Services have a $45 copay with no coinsurance, and Worldwide Emergency Services have a $110 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, each with no coinsurance.
Primary Care See details
Primary Care Physician Services have no copay. Chiropractic Services have a 20% coinsurance. Occupational Therapy Services have a $35 copay. Physician Specialist Services have a $45 copay. Mental Health Specialty Services, Individual and Group Sessions have a $40 copay. Physical Therapy and Speech-Language Pathology Services have a $35 copay. Additional Telehealth Benefits have a copay between $0 and $45. Opioid Treatment Program Services have a copay between $40 and $85.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, kidney disease education services with no copay, and other preventive services including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Additional preventive services are also covered, but there may be a copay for some services. Some services, such as Health Education, In-Home Safety Assessment, and others, are not covered.
Hearing Services See details
The Humana Gold Plus H3533-033 (HMO) plan covers hearing exams with a $45 copay, and routine hearing exams with no copay. This plan also covers fitting/evaluation for hearing aids with no copay, and OTC hearing aids with a maximum benefit of $50 every three months. Prescription hearing aids are partially covered, with all types covered at a copay between $699 and $999, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay between $0 and $45, while routine eye exams have no copay. Eyewear, including contact lenses and eyeglasses (lenses and frames), has no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $45 copay, as well as Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), and Other Preventive Dental Services with no copay. Fluoride Treatment, Restorative Services, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered. Adjunctive General Services are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H3533-033 (HMO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 5% coinsurance, Prosthetic Devices with 5% coinsurance, Medical Supplies with 5% coinsurance, and Diabetic Equipment. Diabetic Supplies have a 5-10% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a copay for Medicare-covered diagnostic procedures/tests and lab services, with a maximum copay of $95 for diagnostic procedures/tests and no copay for lab services. Radiological Services have a copay for Medicare-covered diagnostic and therapeutic radiological services and a coinsurance for Medicare-covered X-ray services, with a copay of up to $720 for diagnostic radiological services and a minimum 20% coinsurance for therapeutic radiological services. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H3533-033 (HMO) 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 none of the sub-services are covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H3533-033 (HMO) 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
Other Services includes acupuncture with no copay, but requires prior authorization and is limited to 25 treatments per year. Over-the-counter items are covered with a maximum benefit of $50 every three months, and the plan offers nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay, and for a chronic illness, but requires prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing, and others are not covered.
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