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Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H4461-044 (HMO-POS 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 H4461-044 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Missouri. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Gold Plus SNP-DE H4461-044 (HMO-POS 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 H4461-044 (HMO-POS 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 H4461-044 (HMO-POS 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 H4461-044 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.90. 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:
Sign up for Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) plan features an annual drug deductible of $615. For generic medications, members enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs filled at standard pharmacies or through preferred mail order. However, using standard mail order for these generic tiers results in a copay, ranging from $10 to $20 for a one-month supply. For higher-tier medications, including Tier 3 (Preferred Brand), Tier 4 (Non-Preferred Drug), and Tier 5 (Specialty Tier), members are responsible for a 25% coinsurance. This 25% coinsurance rate applies across standard pharmacies, preferred mail order, and standard mail order services. This consistent cost-sharing structure helps you easily project your out-of-pocket expenses for brand-name and specialty prescriptions.
Additional Benefits
The Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) plan offers comprehensive coverage where many primary care, specialist, outpatient, and diagnostic services feature no copay and a 20% coinsurance. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care, both with no coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted within 24 hours, while ground ambulance services require a $335 copay. This plan also provides strong supplemental benefits, including up to $5,000 in dental coverage and up to $2,000 per ear for hearing aids with no copay or coinsurance. Additionally, members receive a $500 annual eyewear allowance, no-cost home health services, and up to 24 yearly one-way trips to plan-approved locations. Preventive services, over-the-counter items, and chronic illness meals are also fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) offers partially covered 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. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copay and a 20% coinsurance. Prior authorization is required for these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP), offering ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 24 yearly one-way trips to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS 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 no copay and a 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent, and transportation services are all covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) covers primary care, specialist, therapy, mental health, and telehealth services with no copay and 20% coinsurance, though prior authorization is often required. Podiatry and chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and memory fitness. However, the plan does not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional tobacco cessation, enhanced disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Hearing services are covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP), offering routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids (up to $2,000 per ear) and OTC hearing aids are covered with no copay and no coinsurance, though prescription aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP), featuring one routine eye exam per year with no copay, 20% coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is also partially covered with no copay, no coinsurance, and a $500 annual limit for one pair of eyeglasses or contact lenses, excluding individual eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental services are partially covered under the Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) plan, featuring no copay and 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for other dental services up to a $5,000 annual maximum. 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 SNP-DE H4461-044 (HMO-POS D-SNP) with prior authorization, requiring 0% to 20% coinsurance for Medicare Part B drugs. Covered insulin drugs have a $35 copay with no deductible, other Part B drugs have no copay, and step therapy may apply.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic supplies. 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 H4461-044 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests, lab services, and outpatient X-rays require a 20% coinsurance with no copay for tests and labs, while diagnostic radiological services require a $200 copay and 20% coinsurance.
Home Health Services See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) indicates some services are covered under cardiac rehabilitation with no copay and prior authorization required. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Patients pay no copay for days 1 through 20, followed by a $218 daily copay 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 H4461-044 (HMO-POS D-SNP) covers acupuncture with no copay and 20% coinsurance, as well as over-the-counter items and chronic illness meals with no copay and no coinsurance. Some other supplemental services under this benefit category are not covered, and prior authorization is required for acupuncture and meals.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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