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Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Greater Georgia 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 SNP-DE H4141-024 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP).
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 SNP-DE H4141-024 (HMO D-SNP), 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 $615.00 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 SNP-DE H4141-024 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when using standard pharmacies or preferred mail order services for both 1-month and 3-month supplies. Standard mail order delivery for these tiers requires a copay, ranging from $10 to $30 for Tier 1 and $20 to $60 for Tier 2. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order. This 25% coinsurance applies to both 1-month and 3-month supplies for Tiers 3 and 4, while Tier 5 specialty medications are limited to a 1-month supply.
Additional Benefits
The Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) offers comprehensive medical coverage with clearly defined cost-sharing for its members. Inpatient hospital stays require no coinsurance but carry a copay of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. Outpatient services, primary care, specialist visits, and dialysis require no copay but are subject to a 20% coinsurance, while emergency room visits feature a $115 copay with no coinsurance. This plan also provides valuable supplemental benefits, including preventive and comprehensive dental services with no copay or coinsurance up to a $2,500 annual limit. Routine vision exams feature no copay and a 20% coinsurance, complemented by a $200 annual allowance for eyewear with no copay or coinsurance. Furthermore, preventive services, home health care, and over-the-counter items are covered with no copays and no coinsurance to help keep healthcare costs low.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) inpatient hospital benefits are partially covered, requiring no coinsurance alongside a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required, and specific sub-services like upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) with no copay and a 20% coinsurance, with prior authorization required. This includes outpatient hospital, observation, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, which have no deductible.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. Routine transportation services are not covered by this plan.
Emergency Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) 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 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers primary care, specialist, therapy, mental health, psychiatric, and telehealth services with no copay and 20% coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance, including annual physical exams, kidney education, glaucoma screenings, and a memory fitness benefit. Sub-services that are not covered include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services covered by Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) include routine hearing exams with a 20% coinsurance and no copay, alongside fitting evaluations and OTC hearing aids with no copays or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance for up to two aids every three years, though inner ear, outer ear, and over the ear models are not covered. There is no deductible for any of these covered hearing benefits.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) with no deductibles, though prior authorization is required. Routine eye exams are covered once per year with no copay and 20% coinsurance, and eyewear is covered up to a $200 annual limit with no copay or coinsurance, though other eye exams, standalone eyeglass lenses, standalone frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) offers partially covered dental services with an annual maximum limit of $2,500. Covered preventive and comprehensive services have no copay and no coinsurance, while Medicare-covered dental services have no copay and a 20% coinsurance; however, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers home infusion bundled services with prior authorization, offering Medicare Part B insulin for a $35 copay and 0% to 20% coinsurance. Other covered Medicare Part B drugs, including chemotherapy and radiation, feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with a 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers diagnostic and radiological services, which require prior authorization. Diagnostic procedures and lab services feature no copay, while outpatient X-rays have a $50 copay and diagnostic radiological services have a $200 copay, with a 20% coinsurance applying to all of these covered services.
Home Health Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers home health services 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 SNP-DE H4141-024 (HMO D-SNP) with no copay and require prior authorization, though only some services are covered in practice. Standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a daily copay of $218 for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus SNP-DE H4141-024 (HMO D-SNP) covers acupuncture with no copay and a 20% coinsurance for up to 20 treatments per year, as well as meal benefits and partially covered over-the-counter (OTC) items with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and the OTC benefit is delivered via reimbursement and does not cover all CMS OTC list drugs.
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