Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP)

Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Houston, Dallas-Fort Worth, and East Texas areas. 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 H4461-072 (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 H4461-072 (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 H4461-072 (HMO D-SNP) prescription drug plan features an annual drug deductible of $290. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using standard pharmacies or preferred mail order services for 1-month and 3-month supplies. If you choose standard mail order, Tier 1 drugs have a $10 to $30 copay, while Tier 2 drugs carry a $20 to $60 copay depending on the supply duration. For higher-tier medications, Tier 3 preferred brand and Tier 4 non-preferred drugs require a 25% coinsurance across standard pharmacies, preferred mail order, and standard mail order. Tier 5 specialty drugs carry a 29% coinsurance for a 1-month supply through standard pharmacies, preferred mail order, and standard mail order channels. This straightforward cost structure helps you easily calculate your potential out-of-pocket expenses for this Medicare plan.

Additional Benefits

The Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP) plan offers comprehensive medical coverage with no copay and a 20% coinsurance for primary care, outpatient services, and dialysis. For inpatient hospital stays, members pay no coinsurance but are responsible for a copayment of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. Emergency services are available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features robust supplemental benefits, including home health services, preventive care, and select over-the-counter items with no copay and no coinsurance. Routine dental, vision, and hearing exams are available with no copay and a 20% coinsurance, alongside allowances for eyewear up to $300 annually and other dental services up to $3,000 annually. Additionally, members can access up to 48 one-way transportation trips per year to plan-approved locations at no cost.