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Humana Total Complete Giveback H4461-047 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Total Complete Giveback H4461-047 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Total Complete Giveback H4461-047 (HMO-POS) in 2026, please refer to our full plan details page.
Humana Total Complete Giveback H4461-047 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in Kansas City, MO-KS. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Humana Total Complete Giveback H4461-047 (HMO-POS) 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 Total Complete Giveback H4461-047 (HMO-POS).
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 Total Complete Giveback H4461-047 (HMO-POS), 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. Additionally, this plan comes with a Part B Premium reduction of $58.00. You must continue to pay paying your reduced 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 $4200.00 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 Total Complete Giveback H4461-047 (HMO-POS) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies or through preferred mail order, while standard mail order costs $10 for a one-month supply. Tier 2 generic drugs cost $5 for a one-month supply at standard pharmacies and preferred mail order, with no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, with a three-month supply costing $131 through preferred mail order and $141 at standard pharmacies. Tier 4 non-preferred drugs carry a 50% coinsurance for both standard pharmacies and mail order options. Tier 5 specialty drugs require a 25% coinsurance for a one-month supply across all available pharmacy and mail order channels.
Additional Benefits
The Humana Total Complete Giveback H4461-047 (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive screenings, and home health care. Specialist visits carry a $30 copay, while inpatient hospital stays require a $375 daily copay for days one through seven, with no copay thereafter. Emergency care is available with a $130 copay, which is waived upon hospital admission. Supplemental benefits include routine dental care with no copay up to a $3,000 annual limit, and routine vision care with no copay up to a $100 annual limit for eyewear. Routine hearing exams and over-the-counter hearing aids also feature no copay, while medical equipment typically requires a 15% to 20% coinsurance. Members can also access over-the-counter items and chronic illness meals with no copay or coinsurance.
Inpatient Hospital See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $375 daily copay for days 1 to 7, with no copay for day 8 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $334 daily copay for days 1 to 7, and no copay for days 8 to 90, though prior authorization is required and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for hospital visits and a $375 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions carry a $30 to $35 copay.
Partial Hospitalization See details
Humana Total Complete Giveback H4461-047 (HMO-POS) 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 Total Complete Giveback H4461-047 (HMO-POS) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. These costs are not waived if you are admitted to the hospital, and transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical, occupational, and speech therapies, and mental health services require a $30 copay and no coinsurance. Additional telehealth services are available with a $0 to $65 copay and no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Humana Total Complete Giveback H4461-047 (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, memory fitness, and various screenings. However, several supplemental services are not covered, including 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, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams have a $30 copay and no coinsurance. Over-the-counter (OTC) hearing aids are covered with no copay or coinsurance, whereas prescription hearing aids are only partially covered with a $699 to $999 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
Vision services are partially covered by Humana Total Complete Giveback H4461-047 (HMO-POS), featuring one routine eye exam and eyewear (contact lenses or eyeglasses) per year with no copay, no coinsurance, and no deductible, up to a $100 combined annual limit. Prior authorization is required, and benefits do not cover other eye exams, separate eyeglass lenses, eyeglass frames, or upgrades.
Dental Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) dental services are partially covered up to $3,000 annually, with Medicare-covered dental requiring a $30 copay and no coinsurance. Most covered preventive and comprehensive services have no copay and no coinsurance, while prosthodontics require no copay and 30% coinsurance; however, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Humana Total Complete Giveback H4461-047 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by Humana Total Complete Giveback H4461-047 (HMO-POS), featuring a 20% coinsurance and no copay for durable medical equipment (DME) and prosthetics, and a 15% coinsurance with no copay for medical supplies. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Total Complete Giveback H4461-047 (HMO-POS) with no coinsurance, though prior authorization is required. Members pay no copay for lab and outpatient X-ray services, while diagnostic procedures and tests range from a $0 to $65 copay, and therapeutic radiological services start at a $20 copay.
Home Health Services See details
Home health services are covered by Humana Total Complete Giveback H4461-047 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Total Complete Giveback H4461-047 (HMO-POS) provides coverage for Cardiac Rehabilitation Services with no coinsurance and prior authorization required, though only some services are covered in practice. Specifically, cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($20 copay), and SET for PAD services (no copay) are not covered.
Skilled Nursing Facility (SNF) See details
The Humana Total Complete Giveback H4461-047 (HMO-POS) plan covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Total Complete Giveback H4461-047 (HMO-POS), as Dual Eligible SNPs with Highly Integrated Services are not covered. Covered benefits include acupuncture with a $30.00 copay and no coinsurance (up to 20 treatments per year), as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
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