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Humana Gold Plus SNP-DE H4461-076 (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 H4461-076 (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 H4461-076 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H4461-076 (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 H4461-076 (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 H4461-076 (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 H4461-076 (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 H4461-076 (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 $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:
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Drug Coverage
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) offers an enhanced alternative drug benefit with a $615 prescription drug deductible. If you qualify for the low-income subsidy (LIS), your drug premium may be reduced to $0. During the initial coverage phase, which lasts until total drug costs reach $2,100, you will pay a 25% coinsurance for standard generics, preferred brands, and non-preferred drugs. For preferred generic drugs, this plan offers no copay at standard pharmacies and preferred mail delivery, though standard mail delivery carries a $20 copay. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) offers structured coverage for core medical needs, utilizing a combination of flat copays and a standard 20% coinsurance. Inpatient hospital stays require a copay of $2,230 for acute care or $2,080 for psychiatric care with no coinsurance, while primary care, specialist visits, and many outpatient services carry no copay and a 20% coinsurance. Emergency room visits require a $115 copay that is waived upon admission, while urgent care services are available with no copay and a 20% coinsurance. This plan also includes valuable supplemental benefits, such as home health care and up to 76 one-way trips to approved locations with no copay and no coinsurance. Dental services feature a generous $4,000 annual limit with no copay and no coinsurance for covered preventive and comprehensive care, alongside a $500 yearly allowance for eyeglasses and contact lenses. Furthermore, routine preventive services, over-the-counter items, and meal benefits are fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) partially covers inpatient hospital services, requiring a $2,230 copay per stay and no coinsurance for acute care, and a $2,080 copay per stay and no coinsurance for psychiatric care. Prior authorization is required, but non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP), including outpatient hospital care for a $400 copay and 20% coinsurance, and ambulatory surgical center services for a $325 copay and 20% coinsurance. Outpatient substance abuse, observation, and blood services are also covered with 20% coinsurance and no copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) with a 20% coinsurance and no copay. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) covers 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 76 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H4461-076 (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 no copay and a 20% coinsurance, while worldwide emergency, urgent, and transportation services require a $115 copay and no coinsurance.
Primary Care See details
Primary Care benefits are covered by Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP), with most services, including physician, specialist, and therapy visits, requiring a 20% coinsurance and no copay. Medicare-covered podiatry and routine chiropractic care (up to 12 visits per year) are covered with no copay, and telehealth services carry a 20% coinsurance and no copay.
Preventive Services See details
Preventive services are partially covered under Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) with no copay and no coinsurance for covered options like annual physical exams, glaucoma screenings, and kidney disease education. 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, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, caregiver support, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) covers routine hearing exams with a 20% coinsurance and no copay, while fitting evaluations and OTC hearing aids have no copays or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every three years, 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 H4461-076 (HMO D-SNP), featuring one annual routine eye exam with no copay and a 20% coinsurance. The plan also covers contact lenses and eyeglasses with no copay and no coinsurance up to a $500 yearly limit, though separate eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) partially covers dental services, offering a $4,000 annual limit with no copay and no coinsurance for covered preventive and comprehensive care. Medicare-covered dental services require a 20% coinsurance and no copay, while fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) with prior authorization. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while other Part B chemotherapy and general drugs range from no coinsurance to 20% coinsurance with no copay for general drugs.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with a 20% coinsurance and no copay. Prior authorization is required for these benefits, which also cover diabetic therapeutic shoes and inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) and require prior authorization. Covered services feature a 20% coinsurance, with copayments ranging from no copay for lab work and diagnostic tests, to $50 for outpatient X-rays, and between $200 and $780 for diagnostic radiological services.
Home Health Services See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required before you can receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice by the Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) plan. This includes standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services, all of which are not covered and have no associated copays or coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H4461-076 (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services 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 H4461-076 (HMO D-SNP), excluding highly integrated services for dual-eligible SNPs. Covered options include acupuncture with a 20% coinsurance and no copay, alongside over-the-counter items and meal benefits with no copay and no coinsurance.
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