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Humana Gold Plus H4141-015 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H4141-015 (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 H4141-015 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H4141-015 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Atlanta Metro 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 H4141-015 (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 H4141-015 (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 H4141-015 (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 $350.00 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 H4141-015 (HMO) plan features a $350 prescription drug deductible. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies or through preferred mail order. Tier 2 generic drugs carry a low $5 copay for a 1-month supply, which drops to no copay for a 3-month supply when filled via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply at standard pharmacies and mail order services. For higher-tier medications, members pay a percentage of the drug cost, which includes a 43% coinsurance for Tier 4 non-preferred drugs and a 29% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The Humana Gold Plus H4141-015 (HMO) plan features no copay for primary care visits, preventive care, and home health services, while specialist visits require a $30 copay. For hospital care, inpatient stays carry a $375 daily copay for the first several days followed by no copay, and emergency services require a $115 copay that is waived upon admission. Skilled nursing facility stays also offer no copay for the first 20 days before a daily copay applies. Routine dental and vision services are highly accessible, featuring no copay up to annual limits of $1,750 and $250 respectively. Routine hearing exams also require no copay, with prescription hearing aids covered under copays ranging from $99 to $399. For specialized medical needs, durable medical equipment and dialysis services require no copay but carry a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus H4141-015 (HMO) partially covers inpatient hospital services with no coinsurance, excluding upgrades and non-Medicare-covered stays. For acute inpatient stays, there is a $375 daily copay for days 1 to 7 and no copay for days 8 and beyond, whereas psychiatric stays require a $375 daily copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Humana Gold Plus H4141-015 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services carry a $0 to $450 copay ($375 per stay for observation) with no coinsurance, while outpatient substance abuse individual and group sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by the Humana Gold Plus H4141-015 (HMO) plan with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus H4141-015 (HMO), with Medicare-covered ground and air ambulance services requiring prior authorization and a $335 copay with no coinsurance. 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 H4141-015 (HMO) 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 $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H4141-015 (HMO) features primary care physician visits with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay, and mental health services have a $35 copay, both with no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Humana Gold Plus H4141-015 (HMO) with no copay and no coinsurance for annual physicals, kidney education, memory fitness, and select screenings. Uncovered services include health education, in-home safety, PERS, medical nutrition, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Humana Gold Plus H4141-015 (HMO) covers hearing exams with a $30 copay for Medicare-covered exams, no copay for routine exams and fittings, and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $99 to $399 for up to two aids per year, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the Humana Gold Plus H4141-015 (HMO) plan, offering routine eye exams, contact lenses, and eyeglasses (lenses and frames) with no copay, no coinsurance, and no deductible, up to a $250 annual maximum. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered under this benefit.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H4141-015 (HMO), featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other dental services up to a $1,750 annual limit. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Humana Gold Plus H4141-015 (HMO) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Humana Gold Plus H4141-015 (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Gold Plus H4141-015 (HMO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with prior authorization, no copay, and a 20% coinsurance. Diabetic equipment is also covered with prior authorization, featuring no copay and 10% to 20% coinsurance for supplies, and a $10 copay with coinsurance for therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Humana Gold Plus H4141-015 (HMO) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures feature no coinsurance and a copay ranging from $0 to $120, while lab services and outpatient X-rays have no copay. Diagnostic radiology copays start at $0, and therapeutic radiology requires a minimum $30 copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H4141-015 (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Humana Gold Plus H4141-015 (HMO) with no coinsurance and require prior authorization. While some services are covered, standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy for PAD ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H4141-015 (HMO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required for these services, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Humana Gold Plus H4141-015 (HMO) provides partial coverage for other services, including up to 20 acupuncture treatments per year for a $30.00 copay and no coinsurance, and a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
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