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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. 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 $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) prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, you will pay no copay when using standard pharmacies or preferred mail order services for both 1-month and 3-month supplies. Tier 2 generic drugs are also highly affordable, featuring a $5 copay for a 1-month supply at standard pharmacies and no copay for a 3-month supply through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, which can be filled for a reduced $131 copay for a 3-month supply via preferred mail order. For higher-tier medications, Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs carry a 29% coinsurance. Choosing the right pharmacy and mail delivery method can help you maximize savings and manage your healthcare expenses with this Humana HMO plan.
Additional Benefits
The Humana Gold Plus H4141-017 (HMO) plan offers affordable healthcare coverage with no copay for primary care visits and a low $10 copay for specialist visits. Emergency care is available for a $130 copay, which is waived upon admission, while inpatient hospital stays require a $295 daily copay for the first few days and no copay thereafter. Outpatient services and diagnostic procedures are covered with no coinsurance and variable copays depending on the specific service. This plan also includes comprehensive dental, vision, and hearing benefits, featuring no copays for routine eye exams, routine hearing exams, and most dental procedures. Additionally, members benefit from a $1,500 annual dental limit and a $300 yearly allowance for eyeglasses or contacts. Home health services are covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
Humana Gold Plus H4141-017 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 8 of acute stays (with no copay for days 9 and beyond) and days 1 through 6 of psychiatric stays (with no copay for days 7 through 90). Upgrades, non-Medicare-covered stays, and additional days for psychiatric hospitalizations are not covered.
Outpatient Services See details
Humana Gold Plus H4141-017 (HMO) covers outpatient services with no coinsurance, featuring a $0 to $450 copay for outpatient hospital services, a $295 copay per stay for observation services, and no copay for ambulatory surgical center and blood services. Outpatient substance abuse sessions require a $35 copay with no coinsurance, and prior authorization is required for most of these services.
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 receive 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, which require prior authorization. Routine transportation services to health-related locations are not covered under this plan.
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) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 copay and no coinsurance. Therapy services require a $25 copay, psychiatric and mental health services require a $35 copay, and telehealth services range from a $0 to $50 copay, all with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus H4141-017 (HMO) covers essential preventive services, including annual physical exams, kidney education, glaucoma screenings, diabetes training, digital rectal exams, and EKGs, with no copay and no coinsurance. Additional preventive services are partially covered, offering a memory fitness benefit with no copay and no coinsurance, while sub-services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, safety devices, and counseling are not covered.
Hearing Services See details
Humana Gold Plus H4141-017 (HMO) hearing services are partially covered with no deductible, offering Medicare-covered exams for a $10 copay and routine exams or fitting evaluations with no copay, all with no coinsurance. Up to two prescription hearing aids are covered per year with no coinsurance and a copay between $599 and $899, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H4141-017 (HMO) vision services are partially covered with no deductibles and no coinsurance, offering no copay for one annual routine eye exam and up to $300 yearly for contact lenses or eyeglasses. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H4141-017 (HMO) partially covers dental services, offering a $1,500 annual maximum benefit for non-Medicare dental care with no copay and no coinsurance, while Medicare-covered dental services require a $10 copay and no coinsurance. Most preventive and comprehensive procedures are covered with no copay and no coinsurance, though fluoride treatments, 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 and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a 0% to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H4141-017 (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H4141-017 (HMO) covers medical equipment, including durable medical equipment (DME) and prosthetics, with 20% coinsurance and no copay. Diabetic supplies are covered with 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H4141-017 (HMO) covers diagnostic and radiological services with prior authorization, offering diagnostic services with no coinsurance, no copay for lab services, and a $0 to $120 copay for diagnostic procedures. Diagnostic radiological services and outpatient X-rays feature no copay, while therapeutic radiological services require a minimum 20% coinsurance and a minimum $10 copay.
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) technically covers Cardiac Rehabilitation Services with no coinsurance, but in practice, only some services are covered. Specifically, cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H4141-017 (HMO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, but a prior three-day inpatient hospital stay is not, and additional days beyond Medicare-covered limits are not covered.
Other Services See details
Humana Gold Plus H4141-017 (HMO) partially covers Other Services, offering acupuncture with a $10.00 copay and no coinsurance for up to 20 treatments per year, though prior authorization is required. Over-the-counter (OTC) items, meal benefits, and other supplemental services are not covered under this plan.
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