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Humana Gold Plus SNP-DE H4141-003 (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 H4141-003 (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 H4141-003 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Greater Georgia Area. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus SNP-DE H4141-003 (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 H4141-003 (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 H4141-003 (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 H4141-003 (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 H4141-003 (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when using a standard pharmacy or preferred mail order services. However, standard mail order fills for these generic tiers require a copay, ranging from $10 to $20 for a one-month supply and $30 to $60 for a three-month supply. For Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan charges a consistent 25% coinsurance. This 25% coinsurance rate applies to standard pharmacies, preferred mail order, and standard mail order for all available supply lengths. This straightforward cost-sharing structure makes it easy to project your potential out-of-pocket medication expenses under this Medicare Advantage plan.
Additional Benefits
The Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) offers robust medical coverage with no copays for preventive services, home health care, and primary or specialist visits, although a 20% coinsurance applies to most doctor and outpatient services. Inpatient hospital stays require a $2,230 copay for acute care and a $2,080 copay for psychiatric care with no coinsurance, while emergency room visits carry a $115 copay. Skilled nursing facility stays are also covered with no copay for the first 20 days. This plan also includes valuable supplemental benefits, such as dental coverage up to $2,000 annually with no copays or coinsurance for most services. Additionally, members benefit from hearing aid coverage every three years and a $100 annual eyewear allowance with no copays or coinsurance. Durable medical equipment, dialysis, and diagnostic tests are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. While unlimited additional acute care days are covered with no copay, prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) with no copays, though a 20% coinsurance and prior authorization apply to most services. This includes coverage for outpatient hospital visits, observation services, ambulatory surgical center procedures, outpatient substance abuse sessions, and outpatient blood services.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers Medicare-approved ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H4141-003 (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 are covered with a 20% coinsurance (up to a $40 maximum per visit) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers primary care, specialist visits, mental health, and therapy services with no copay and a 20% coinsurance. Chiropractic and podiatry services are not covered under this plan, and prior authorization is required for most specialist and therapy benefits.
Preventive Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. However, additional preventive services are only partially covered, with exclusions including health education, in-home safety assessments, PERS, medical nutrition therapy, weight management, alternative therapies, and nutritional benefits.
Hearing Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) partially covers hearing services with no deductible, offering fitting evaluations, OTC hearing aids, and up to two prescription hearing aids every three years with no copay and no coinsurance. Routine hearing exams are covered with no copay and a 20% coinsurance, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP), featuring one annual routine eye exam with no copay and 20% coinsurance, while other eye exams are not covered. Covered eyewear has no copay, no coinsurance, and a $100 yearly limit for one pair of contact lenses or eyeglasses (lenses and frames), but individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) offers partially covered dental services with an annual maximum of $2,000, featuring no copay and no coinsurance for most preventive and comprehensive services. Medicare-covered dental services require no copay and a 20% coinsurance, while excluded services include fluoride treatments, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics.
Home Infusion bundled Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers home infusion bundled services, which require prior authorization and step therapy. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, other Part B drugs have no copay and no coinsurance to 20% coinsurance, and chemotherapy drugs require a copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with a 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) covers diagnostic and radiological services under prior authorization, with a 20% coinsurance applying to all covered services. Diagnostic tests, procedures, and lab services require no copay, while outpatient X-rays have a $50 copay and diagnostic radiological services require a $200 copay.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) with no copay, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan are partially covered, offering acupuncture with no copay and 20% coinsurance, alongside meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are also covered through reimbursement with no copay and no coinsurance, while other specific 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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