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Humana Gold Plus SNP-DE H4141-025 (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 H4141-025 (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 H4141-025 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4141-025 (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 H4141-025 (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 H4141-025 (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 H4141-025 (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 H4141-025 (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 H4141-025 (HMO D-SNP) has a drug deductible of $615. For Tier 1 preferred generic, Tier 2 generic, and Tier 3 preferred brand drugs, there is no copay for one-month and three-month supplies at standard pharmacies and preferred mail order. If you use standard mail order for these tiers, copays range from $10 to $47 for a one-month supply and $30 to $141 for a three-month supply. Tier 4 non-preferred drugs require a 25% coinsurance for one-month and three-month supplies at standard pharmacies and all mail order options. Tier 5 specialty tier drugs also carry a 25% coinsurance for a one-month supply across standard pharmacies and mail order. Understanding these copays and coinsurance rates can help you estimate your annual out-of-pocket prescription costs with this plan.
Additional Benefits
The Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) offers comprehensive medical coverage, featuring no copays for doctor visits and outpatient hospital services, though a 20% coinsurance typically applies. Inpatient hospital stays require a copay of $2,230 per acute stay with no coinsurance, while skilled nursing facility care has no copay for the first 20 days. Emergency room visits carry a $115 copay, which is waived upon admission, and ground or air ambulance services require a $335 copay. This plan also includes valuable supplemental benefits, such as preventive care, home health services, and over-the-counter items with no copay and no coinsurance. Dental benefits are covered with no copay or coinsurance up to a $2,500 annual limit, and vision benefits provide up to $300 yearly for eyewear with no copay or coinsurance. Additionally, routine hearing exams and hearing aids are covered with no copay, though routine exams and other medical equipment require a 20% coinsurance.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. While unlimited additional acute care days are covered with no copay, prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) are covered with no copay, though a 20% coinsurance and prior authorization requirements apply to most benefits. Covered care includes outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, with the deductible waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization is covered by the Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers ground and air ambulance services with a $335.00 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations are not covered in practice.
Emergency Services See details
Humana Gold Plus SNP-DE H4141-025 (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 require a 20% coinsurance (up to $40) and no copay, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers primary care, specialist, occupational and physical therapy, mental health, psychiatric, telehealth, and opioid treatment services with no copay and 20% coinsurance. Chiropractic and podiatry services are not covered under this plan, and prior authorization is required for most specialist and therapy services.
Preventive Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. However, additional preventive benefits are only partially covered, excluding services such as health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers hearing services with no deductible, offering routine exams once per year with a 20% coinsurance and no copay, and unlimited fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance for up to two devices every three years, excluding inner ear, outer ear, and over the ear models. Unlimited OTC hearing aids are also covered with no copay and no coinsurance.
Vision Services See details
Vision Services are partially covered by Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP), featuring routine eye exams with no copay and a 20% coinsurance, and up to $300 yearly for eyewear with no copay or coinsurance. Other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) dental benefits are partially covered up to a $2,500 annual limit, featuring no copay and a 20% coinsurance for Medicare-covered dental services. Other covered preventive and comprehensive services have no copay and no coinsurance, though fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) with prior authorization and step therapy. Covered insulin requires a $35 copay and no coinsurance to 20% coinsurance, chemotherapy drugs require a copay and no coinsurance to 20% coinsurance, and other Part B drugs carry no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with 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
Diagnostic and radiological services are covered under the Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) subject to prior authorization and a 20% coinsurance. Members pay no copay for lab services and diagnostic procedures, a $50 copay for outpatient X-rays, and a $200 copay for diagnostic radiological services.
Home Health Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) covers some cardiac rehabilitation services with no copay and prior authorization required, but several key sub-services are not covered. Specifically, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H4141-025 (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, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services covered by Humana Gold Plus SNP-DE H4141-025 (HMO D-SNP) include acupuncture, over-the-counter (OTC) items, and chronic illness meal benefits, though some other services are not covered. Acupuncture is limited to 20 treatments per year with no copay and a 20% coinsurance, while OTC items and meal benefits are offered with no copay and no coinsurance.
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