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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 2025, 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 4 out of 5 stars in 2025.
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 $3.00. 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 $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 H4141-015 (HMO) plan has a $350 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, in the initial coverage phase, you will pay a $5 copay for preferred generic drugs at a standard pharmacy, or 35% coinsurance for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for Part D covered drugs.
Additional Benefits
The Humana Gold Plus H4141-015 (HMO) plan offers a range of benefits, including coverage for inpatient and outpatient services with varying copays. You'll find no copay for primary care, and additional preventive services like fitness benefits and routine hearing exams have no copay. The plan includes coverage for hearing, vision, and dental services, with copays for exams and some procedures, and maximum annual benefits for vision and dental. Ambulance services have a $315 copay, while emergency services have a $110 copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric services, with a copay of $399 per admission for days 1-6, and no copay for days 7-999. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services with a copay between $0 and $450, observation services with a $399 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a copay between $45 and $100 for both individual and group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H4141-015 (HMO) plan, with a copay of $80.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H4141-015 (HMO) plan. Medicare-covered Ground and Air Ambulance Services have a copay of $315, with no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Gold Plus H4141-015 (HMO) plan. Emergency Services has a $110 copay, Urgently Needed Services has a $45 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay. There is no coinsurance for any of these services.
Primary Care See details
The Humana Gold Plus H4141-015 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, and physician specialist services with a $40 copay. Mental health specialty services, psychiatric services, and opioid treatment program services have a $45 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $25 copay, while additional telehealth benefits have a copay between $0 and $45. However, routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services and additional preventive services, with no copay for annual physical exams. Additional preventive services include a fitness benefit with no copay, while services like health education and home-based palliative care are not covered.
Hearing Services See details
The Humana Gold Plus H4141-015 (HMO) plan covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a copay between $599 and $899, while inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a copay of $0-$40, and eyewear benefits including contact lenses and eyeglasses (lenses and frames) with a $0 copay, with a combined maximum benefit of $250 every year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H4141-015 (HMO) plan covers dental services, including Medicare dental services with a $40 copay. Other dental services are covered, with a maximum benefit of $1500 per year. Oral exams, dental x-rays, other diagnostic, prophylaxis (cleaning), other preventive, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery services are covered with no copay, but fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H4141-015 (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have a 10% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests, and lab services, with a copay of up to $110 for diagnostic procedures and tests, and no copay for lab services. Radiological Services include coverage for diagnostic, therapeutic, and outpatient X-ray services with a copay of up to $325 for diagnostic, up to $40 for therapeutic, and no copay for outpatient X-ray services; therapeutic services also have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H4141-015 (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the following services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H4141-015 (HMO) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered, as well as non-Medicare-covered stays, are not covered.
Other Services See details
Other Services includes acupuncture and a meal benefit. Acupuncture has a $40 copay and the plan covers up to 20 treatments per year. The meal benefit has no copay. Over-the-counter (OTC) Items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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