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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 2026, 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 2026.
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.
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 $8550.00 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 features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will face 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, requiring no copay for a 3-month supply via preferred mail order or a $5 copay for a 1-month supply at standard pharmacies. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply across standard pharmacies and mail order options. For higher-tier medications, Tier 4 non-preferred drugs require 26% coinsurance, while Tier 5 specialty drugs require 25% coinsurance for a 1-month supply. These structured copayments and coinsurance rates help you easily estimate your out-of-pocket prescription costs.
Additional Benefits
The Humana Gold Plus H3533-033 (HMO) plan offers robust core medical coverage with predictable costs, including primary care visits with no copay and specialist visits for a $40 copay. Inpatient hospital stays require a $310 daily copay for the first six days and no copay thereafter, while skilled nursing facility stays feature no copay for the first 20 days. Emergency room visits carry a $115 copay, which is waived if you are admitted, and emergency ground or air ambulance services require a $335 copay. Beneficiaries enjoy comprehensive wellness benefits, including preventive services, annual physicals, routine hearing exams, and routine eye exams with eyeglasses or contacts up to a $250 limit, all with no copay or coinsurance. Dental care is covered up to a $1,000 annual limit with no copay for preventive services, though restorative care requires 30% to 40% coinsurance. Home health services and up to 24 one-way transportation trips per year are also covered with no copay, while durable medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H3533-033 (HMO) covers inpatient acute hospital stays with no coinsurance and a daily copay of $310 for days 1 through 6, and no copay for days 7 and beyond. Inpatient psychiatric care is covered with no coinsurance and a daily copay of $305 for days 1 through 6, and no copay for days 7 through 90. These benefits are partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H3533-033 (HMO) covers outpatient services with no coinsurance, including outpatient hospital services with a copay ranging from $0 to $850 and observation services with a $310 copay. Outpatient substance abuse services require a $35 copay with no coinsurance, while ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H3533-033 (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 H3533-033 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus H3533-033 (HMO) covers emergency services 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 covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are all covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H3533-033 (HMO) offers primary care physician visits with no copay and no coinsurance, while specialist visits require a $40 copay and no coinsurance. Physical, occupational, speech, and mental health therapies are covered with a $35 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H3533-033 (HMO) covers Medicare preventive services, annual physical exams, kidney disease education, and various screenings with no copay and no coinsurance. Additional preventive benefits are only partially covered, offering a memory fitness program with no copay, but excluding services such as health education, in-home safety assessments, nutritional therapy, and personal emergency response systems.
Hearing Services See details
Humana Gold Plus H3533-033 (HMO) covers hearing services with no deductible, offering annual routine exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Medicare-covered exams require a $40 copay with no coinsurance, and prescription hearing aids are partially covered with a copay of $299 to $899 and no coinsurance, excluding inner ear, outer ear, and over-the-ear types.
Vision Services See details
Humana Gold Plus H3533-033 (HMO) vision services feature no copay, no coinsurance, and no deductible for an annual routine eye exam and a pair of eyeglasses or contact lenses, up to a $250 yearly limit. Other eye exams, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H3533-033 (HMO) provides partially covered dental services up to a $1,000 annual limit, featuring no copay and no coinsurance for preventive care, endodontics, periodontics, and oral surgery, while Medicare-covered dental services require a $40 copay and no coinsurance. Restorative and fixed prosthodontics have no copay with 30% to 40% coinsurance, but fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H3533-033 (HMO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance to 20%, with Part B insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H3533-033 (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Gold Plus H3533-033 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Covered diabetic supplies carry a 10% to 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H3533-033 (HMO) covers diagnostic and radiological services, requiring prior authorization for both. Diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $95, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Humana Gold Plus H3533-033 (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H3533-033 (HMO) offers Cardiac Rehabilitation Services with no coinsurance and required prior authorization, though only some services are covered. In practice, cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H3533-033 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring 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 H3533-033 (HMO) partially covers other services, offering acupuncture with a $20 copay and no coinsurance for up to 25 treatments per year, alongside over-the-counter items and chronic illness meal benefits with no copay or coinsurance. Certain other miscellaneous services and highly integrated services for dual-eligible SNPs are not covered under this plan.
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