Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP)

Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in San Antonio, Corpus Christi, RGV, El Paso Metro. 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 H4461-069 (HMO D-SNP) 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 Gold Plus SNP-DE H4461-069 (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.

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:

Drug Coverage

The Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For generic medications, members enjoy no copay for Tier 1 preferred generics and Tier 2 generics when using a standard pharmacy or preferred mail order. Standard mail order delivery for these generic tiers requires a copay, which ranges from $10 to $20 for a one-month supply and up to $60 for a three-month supply. For brand-name and specialty medications, the cost-sharing structure transitions to coinsurance. Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all carry a 25% coinsurance rate. This 25% coinsurance applies across standard pharmacies, preferred mail order, and standard mail order services, helping you easily project your out-of-pocket costs.

Additional Benefits

The Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP) offers comprehensive healthcare coverage with no copay and no coinsurance for preventive care, home health services, and up to 100 annual one-way transportation trips. For inpatient hospital stays, members pay a set copayment of $2,230 for acute care or $2,080 for psychiatric care with no coinsurance. Most outpatient services, primary care visits, and medical equipment feature no copay and a 20% coinsurance, frequently requiring prior authorization. This plan also provides robust supplemental benefits, including up to $3,000 annually for non-Medicare dental services and a $300 yearly limit for eyewear, both featuring no copay and no coinsurance. Routine hearing exams are covered with a 20% coinsurance and no copay, while over-the-counter hearing aids and other select over-the-counter items require no copay or coinsurance. Skilled nursing facility care is also available with no copay for the first 20 days, followed by a $218 daily copay up to day 100.