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Humana Dual Fully Integrated (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Dual Fully Integrated (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 Dual Fully Integrated (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Dual Fully Integrated (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Statewide: Illinois. The overall rating for this plan is not yet available for 2026.
It's important to know that Humana Dual Fully Integrated (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 Dual Fully Integrated (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 Dual Fully Integrated (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 Dual Fully Integrated (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 $390.00 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 Dual Fully Integrated (HMO D-SNP) prescription drug plan features an annual drug deductible of $390. This plan offers no copay for Tier 1 preferred generics and Tier 2 generics filled at standard pharmacies or through preferred mail order. If you use standard mail order, Tier 1 and Tier 2 drugs require a copay of up to $20 for a one-month supply and up to $60 for a three-month supply. For brand-name and specialty medications, Tier 3 preferred brands and Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty drugs carry a 28% coinsurance, while Tier 6 select care drugs are available with no copay at standard pharmacies and mail order services.
Additional Benefits
The Humana Dual Fully Integrated (HMO D-SNP) plan offers comprehensive coverage for essential medical needs, though cost-sharing applies to several key services. Inpatient acute hospital stays require a copay of $2,230 per admission with no coinsurance, while emergency room visits carry a $115 copay. For outpatient services, primary care, specialist visits, and medical equipment, members will pay no copay and a 20% coinsurance. Preventive care, home health services, and the first 20 days in a skilled nursing facility are covered with no copay and no coinsurance. The plan also features supplemental benefits with no copay and no coinsurance, including routine dental care up to a $500 annual limit, eyeglasses up to a $300 annual limit, hearing aids up to $750 per ear, and over-the-counter items.
Inpatient Hospital See details
Humana Dual Fully Integrated (HMO D-SNP) covers inpatient acute hospital stays with a $2,230 copay per admission and no coinsurance, while inpatient psychiatric stays require a $2,080 copay per admission and no coinsurance. Prior authorization is required for both benefits, and certain services like upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Dual Fully Integrated (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copays and a 20% coinsurance. Prior authorization is required for these outpatient services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Dual Fully Integrated (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Humana Dual Fully Integrated (HMO D-SNP) covers ambulance services with prior authorization, requiring a $335 copay and coinsurance for ground ambulance services, and a 20% coinsurance and copay for air ambulance services. Transportation services are not covered under this plan.
Emergency Services See details
Humana Dual Fully Integrated (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 of 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 Dual Fully Integrated (HMO D-SNP) covers primary care, specialist visits, physical therapy, and mental health services with no copay and a 20% coinsurance. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Humana Dual Fully Integrated (HMO D-SNP) provides coverage for preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. This benefit is partially covered, as the plan includes a memory fitness program but does not cover health education, in-home safety assessments, personal emergency response systems, or nutritional therapy.
Hearing Services See details
Hearing services are covered by Humana Dual Fully Integrated (HMO D-SNP) with no deductible, offering routine exams for a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $750 per ear annually, as inner ear, outer ear, and over the ear hearing aids are not covered. Up to two OTC hearing aids are also covered each year with no copay and no coinsurance.
Vision Services See details
Humana Dual Fully Integrated (HMO D-SNP) offers partial vision coverage, including one routine eye exam and one pair of contact lenses per year with no copay and a 20% coinsurance, as well as one pair of eyeglasses (lenses and frames) with no copay and no coinsurance. Covered eyewear is subject to a combined $300 annual limit, but other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Dual Fully Integrated (HMO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Other covered services like exams, cleanings, and restorative procedures have no copay and no coinsurance up to a $500 annual limit, but fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Dual Fully Integrated (HMO D-SNP) covers home infusion bundled services, with prior authorization and step therapy required. Covered Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while other Part B drugs feature no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Humana Dual Fully Integrated (HMO D-SNP) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Humana Dual Fully Integrated (HMO D-SNP) covers 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 Dual Fully Integrated (HMO D-SNP) covers diagnostic and radiological services, which require prior authorization and a 20% coinsurance. Diagnostic tests, lab services, and outpatient X-rays have no copay, while diagnostic radiological services require a $200 copay.
Home Health Services See details
Humana Dual Fully Integrated (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Humana Dual Fully Integrated (HMO D-SNP) feature no copay and require prior authorization, meaning some services are covered; however, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Dual Fully Integrated (HMO D-SNP) with no coinsurance, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, and a prior three-day inpatient hospital stay is not required for admission.
Other Services See details
Humana Dual Fully Integrated (HMO D-SNP) offers partially covered other services, featuring over-the-counter items and meal benefits with no copay and no coinsurance. Acupuncture is also covered with no copay and 20% coinsurance for up to 20 treatments per year, while other supplemental options (Other 1, 2, 3, and highly integrated services) are not covered.
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