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Humana Gold Plus H4141-017 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H4141-017 (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 H4141-017 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H4141-017 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select counties in Georgia. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H4141-017 (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 H4141-017 (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 H4141-017 (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 $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 $5500.00 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 H4141-017 (HMO) plan features a $350 annual drug deductible. For Tier 1 preferred generic drugs, you will pay 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, costing as little as a $5 copay for a 1-month supply, or no copay for a 3-month supply when using preferred mail order. For Tier 3 preferred brand drugs, copays start at $47 for a 1-month supply, with savings available on 3-month supplies through preferred mail order. Tier 4 non-preferred drugs require a 50% coinsurance across all pharmacy options, while Tier 5 specialty drugs carry a 29% coinsurance for a 1-month supply. This Medicare Advantage plan offers structured copayments and coinsurance options to help manage your prescription drug costs.
Additional Benefits
Humana Gold Plus H4141-017 (HMO) provides comprehensive medical coverage with no copay for primary care visits, routine preventive services, and home health care. Specialist visits require a low $10 copay, while inpatient hospital stays have a $295 daily copay for the first 1 to 8 days and no copay for the remaining days. Emergency room visits carry a $130 copay, which is waived if you are admitted, and outpatient hospital services range from no copay to a $450 copay. This plan also includes valuable everyday benefits, offering routine dental care up to a $2,500 annual limit and routine vision exams with no copay. Routine hearing exams and over-the-counter hearing aids also feature no copay, though prescription hearing aids require a copay ranging from $199 to $499. For medical supplies and durable medical equipment, members can expect a 20% coinsurance with no copay.
Inpatient Hospital See details
Humana Gold Plus H4141-017 (HMO) covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1-8 of acute stays and days 1-6 of psychiatric stays, followed by no copay for remaining covered days. This benefit is partially covered because upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus H4141-017 (HMO) with no coinsurance, although prior authorization is required. Outpatient hospital copays range from $0 to $450, observation services carry a $295 copay per stay, substance abuse sessions have a $35 copay, and ambulatory surgical and blood services feature no copay.
Partial Hospitalization See details
Humana Gold Plus H4141-017 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H4141-017 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance, with prior authorization required. Transportation services are not covered, including trips to plan-approved or any health-related locations.
Emergency Services See details
Humana Gold Plus H4141-017 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H4141-017 (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits for a $10 copay and no coinsurance. Physical, occupational, and speech therapy require a $25 copay with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H4141-017 (HMO) covers key preventive services—including annual physical exams, kidney disease education, and memory fitness—with no copay and no coinsurance. This benefit is partially covered, as supplemental services such as health education, in-home safety assessments, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Humana Gold Plus H4141-017 (HMO) covers hearing services with no coinsurance, featuring a $10 copay for Medicare-covered exams, no copay for routine exams and fitting evaluations, and no copay for OTC hearing aids. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $199 to $499 (limit of two per year), though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H4141-017 (HMO) provides partially covered vision services with no deductible and no coinsurance. There is no copay for one routine annual eye exam and one pair of eyeglasses or contact lenses up to a $150 annual limit, but other eye exams, upgrades, and separate lenses or frames are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H4141-017 (HMO), featuring Medicare-covered dental services for a $10 copay and no coinsurance, and other covered dental benefits with no copay and no coinsurance up to a $2,500 annual maximum. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H4141-017 (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35.00 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H4141-017 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus H4141-017 (HMO), including durable medical equipment, prosthetics, and medical supplies which carry a 20% coinsurance and no copay. Diabetic supplies feature no copay and 10% to 20% coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay and coinsurance.
Diagnostic and Radiological Services See details
Humana Gold Plus H4141-017 (HMO) covers diagnostic and radiological services under prior authorization, featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $120 copay for diagnostic procedures. Outpatient X-rays require no copay, diagnostic radiology has no minimum copay, and therapeutic radiology incurs a minimum $10 copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H4141-017 (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H4141-017 (HMO) covers some cardiac rehabilitation services with no coinsurance, though prior authorization is required. However, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H4141-017 (HMO) with no coinsurance, featuring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not required for admission, additional days beyond the Medicare-covered 100-day limit are not covered.
Other Services See details
Humana Gold Plus H4141-017 (HMO) provides coverage for acupuncture with a $10 copay and no coinsurance, alongside over-the-counter items and meal benefits which both feature no copay and no coinsurance. Other supplemental services and dual eligible SNPs are not covered under this plan.
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