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Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H4461-074 (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 Gold Plus SNP-DE H4461-074 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2026 to people living in Alabama. 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 H4461-074 (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 Gold Plus SNP-DE H4461-074 (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 Gold Plus SNP-DE H4461-074 (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 Gold Plus SNP-DE H4461-074 (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 $565.00 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 Gold Plus SNP-DE H4461-074 (HMO D-SNP) prescription drug plan features an annual drug deductible of $565.00, which can be reduced to $0.00 for individuals who qualify for the low-income subsidy. After meeting the deductible, you enter the initial coverage phase where you pay for your medications until total drug costs reach $2,100.00. During this initial phase, Tier 1 preferred generic drugs have no copay at standard pharmacies or through preferred mail order, while other tiers require a 25% to 26% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs.
Additional Benefits
The Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) provides comprehensive healthcare coverage with clear, structured out-of-pocket costs, featuring no copay and a twenty percent coinsurance for primary care visits alongside a thirty dollar copay for specialists. Inpatient hospital stays require a six hundred and fifty dollar copay for the first three days with no copay for subsequent days, while emergency room services carry a one hundred and fifteen dollar copay. Preventive care, home health services, and routine chiropractic care are fully covered with no copay and no coinsurance. Additionally, members benefit from valuable dental and vision coverage offering no copay or coinsurance up to annual limits of fifteen hundred dollars and three hundred and fifty dollars, respectively. The plan also covers over-the-counter hearing aids and up to thirty-six one-way transportation trips to health-related locations per year with no copay. Over-the-counter items and meals are also provided with no copay and no coinsurance, making this plan a highly supportive option for eligible individuals.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered under Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) with no coinsurance, though prior authorization is required. For acute care, there is a $650 copay for days 1 through 3 and no copay for days 4 through 999, while psychiatric care requires a $615 copay for days 1 through 3 and no copay for days 4 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP), featuring a $0 to $445 copay for outpatient hospital visits and a 20% coinsurance with no copay for observation and blood services. Additionally, ambulatory surgical center services are offered with no copay or coinsurance, while outpatient substance abuse services require a $35 copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers partial hospitalization benefits with a $35 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP), featuring a $335 copay and no coinsurance for ground ambulance services, and a 20% coinsurance and no copay for air ambulance services. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H4461-074 (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 are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services require a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers primary care physician services with a 20% coinsurance and no copay, and specialist visits with a $30 copay and no coinsurance. The plan also covers physical and occupational therapies for a $20 copay, mental health services for a $35 copay, and routine chiropractic care with no copay, all with no coinsurance.
Preventive Services See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for covered care, such as annual physicals and certain screenings. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, disease management, telemonitoring, remote access, home modifications, or counseling.
Hearing Services See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers hearing services with no coinsurance, featuring a $30 copay for hearing exams and no copay for OTC hearing aids. Prescription hearing aids are partially covered with no copay for general types, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP), offering routine eye exams and eyewear with no deductible, no coinsurance, and no copay up to a $350 annual limit. While contact lenses and complete eyeglasses are covered, other eye exams may require a copay up to $30, and individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP), which offers Medicare-covered dental services for a $30 copay and no coinsurance, alongside other covered preventive and comprehensive services up to a $1,500 annual limit with no copays or coinsurance. However, fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers Home Infusion bundled Services with prior authorization, featuring coinsurance ranging from no coinsurance to 20% for covered Part B drugs. Under this benefit, Medicare Part B Insulin Drugs require a $35 copay, other Part B drugs have no copay, and chemotherapy or radiation drugs require a copay.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment benefits are covered under the Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) plan, subject to prior authorization. Durable medical equipment and diabetic supplies require a 20% coinsurance with no copay, while prosthetic devices and medical supplies carry a 20% coinsurance, and diabetic therapeutic shoes and inserts feature no copay.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers diagnostic and radiological services, with prior authorization required for most benefits. Lab services have no copay, diagnostic procedures cost between a $0 to $45 copay plus 20% coinsurance, and radiological services range from a $0 to $780 copay with up to 20% coinsurance on therapeutic and X-ray services.
Home Health Services See details
Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) plan. All related sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP) with no copay for days 1 to 20, a $218 daily copay for days 21 to 100, and no coinsurance. Prior authorization is required, and additional days beyond Medicare-covered SNF services are not covered.
Other Services See details
Other Services are partially covered by Humana Gold Plus SNP-DE H4461-074 (HMO D-SNP), as Dual Eligible SNPs with Highly Integrated Services are not covered. Covered benefits include acupuncture for a $30 copay and no coinsurance, alongside over-the-counter items and meal benefits which require no copay and no coinsurance.
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