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Humana Gold Plus H4141-023 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H4141-023 (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 H4141-023 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H4141-023 (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 H4141-023 (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 H4141-023 (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 H4141-023 (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 $450.00 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 $6750.00 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 H4141-023 (HMO) prescription drug plan features an annual drug deductible of $450. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay for 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. If you use standard mail order, Tier 1 drugs require a $10 copay and Tier 2 drugs require a $20 copay for a 1-month supply. Tier 3 preferred brand drugs cost a $47 copay for a 1-month supply at standard pharmacies and mail order, with savings available on 3-month preferred mail order supplies at $131. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs requiring a 47% coinsurance and Tier 5 specialty drugs requiring a 27% coinsurance for a 1-month supply. This clear cost breakdown helps beneficiaries understand their out-of-pocket expenses for prescriptions under this Humana HMO plan.
Additional Benefits
The Humana Gold Plus H4141-023 (HMO) plan offers robust core medical coverage with no copay or coinsurance for primary care visits, annual physical exams, and home health services. Specialist visits require a $20 copay, while inpatient hospital stays have a $345 daily copay for the first several days before transitioning to no copay. Outpatient hospital services are covered with no coinsurance and a copay up to $450, and emergency care is available with a $130 copay that is waived if you are admitted. This plan also features strong supplemental benefits, including dental coverage up to a $3,500 annual limit with no copay for preventive and comprehensive services. Vision and hearing benefits feature no deductibles or coinsurance, offering no copay for routine exams, OTC hearing aids, and eyewear up to a $250 annual limit. Additionally, diagnostic labs and outpatient X-rays require no copay, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H4141-023 (HMO) inpatient hospital care is partially covered with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. For covered acute stays, there is a $345 daily copay for days 1 through 8 and no copay for days 9 and beyond, while psychiatric stays require a $345 daily copay for days 1 through 6 and no copay for days 7 through 90.
Outpatient Services See details
Humana Gold Plus H4141-023 (HMO) covers outpatient hospital services with no coinsurance and a copay of up to $450, plus a $345 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $35 copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H4141-023 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Humana Gold Plus H4141-023 (HMO) covers Medicare-approved ground and air ambulance services with a $335 copay and no coinsurance, requiring prior authorization. Routine transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Humana Gold Plus H4141-023 (HMO) covers emergency services with a $130 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H4141-023 (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $20 copay and no coinsurance. Physical, occupational, and speech therapies require a $25 copay with no coinsurance, while podiatry is not covered, and chiropractic services are only partially covered because routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Humana Gold Plus H4141-023 (HMO) with no copay and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training. Additional preventive benefits, including fitness programs, health education, weight management, and in-home safety assessments, are not covered.
Hearing Services See details
Humana Gold Plus H4141-023 (HMO) offers hearing services with no deductible and no coinsurance, featuring a $20 copay for Medicare-covered exams and no copay for annual routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with a $299 to $599 copay and no coinsurance for up to two devices per year, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Humana Gold Plus H4141-023 (HMO) covers vision services with no deductibles and no coinsurance, featuring a $0 to $20 copay for eye exams and no copay for eyewear up to a $250 annual limit. The benefit is partially covered, as routine eye exams, contact lenses, and complete eyeglasses are covered, while other eye exams, separate eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H4141-023 (HMO) up to a $3,500 annual limit, featuring a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus H4141-023 (HMO) with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy and other drugs carry no copay and a 0% to 20% coinsurance, while covered Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H4141-023 (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Gold Plus H4141-023 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies and services are also covered, featuring a 10% to 20% coinsurance with no copay for supplies and a $10 copay for therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Humana Gold Plus H4141-023 (HMO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay. Diagnostic procedures require no coinsurance with copays ranging from $0 to $120, while therapeutic radiological services require a minimum $20 copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H4141-023 (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Humana Gold Plus H4141-023 (HMO) with no coinsurance, but some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H4141-023 (HMO) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H4141-023 (HMO) covers acupuncture with a $20 copay and no coinsurance for up to 20 treatments yearly, as well as over-the-counter items and medical meal benefits with no copay and no coinsurance. Other services, including dual-eligible SNP benefits, are not covered under this plan.
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