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Humana Gold Plus H5377-002 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H5377-002 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H5377-002 (HMO-POS) in 2026, please refer to our full plan details page.
Humana Gold Plus H5377-002 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Roanoke. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H5377-002 (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 Gold Plus H5377-002 (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 Gold Plus H5377-002 (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 $1.00. 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 $350.00 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 H5377-002 (HMO-POS) prescription drug plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, there is no copay at standard retail pharmacies or through preferred mail order. Tier 2 generic medications cost a $5 copay for a one-month supply, 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, while a three-month supply costs $131 through preferred mail order and $141 through standard pharmacies. Tier 4 non-preferred drugs carry a 42% coinsurance for both one and three-month supplies. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply across standard pharmacies and mail order options.
Additional Benefits
The Humana Gold Plus H5377-002 (HMO-POS) plan provides affordable access to essential medical care, featuring primary care physician visits and annual physical exams with no copay and no coinsurance. For inpatient acute hospital stays, there is no coinsurance and a $375 daily copay for the first six days, followed by no copay for day seven and beyond. Outpatient diagnostic lab services, outpatient x-rays, and home health services are also covered with no copay and no coinsurance. Specialist visits and Medicare-covered dental services require a $35 copay, while the plan covers routine dental, vision, and hearing exams with no copay. Vision benefits feature a $250 annual limit for eyewear with no copay, and dental services are covered up to a $1,750 annual maximum. Additionally, physical and occupational therapy are available with a $25 copay, though certain services like podiatry, over-the-counter items, and routine transportation are not covered.
Inpatient Hospital See details
Humana Gold Plus H5377-002 (HMO-POS) covers inpatient acute hospital stays with no coinsurance, requiring a $375 daily copay for days 1 through 6 and no copay for day 7 and beyond. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $375 daily copay for days 1 through 5 and no copay for days 6 through 90, while upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Humana Gold Plus H5377-002 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $375 copay for outpatient hospital services and a $375 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H5377-002 (HMO-POS) with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H5377-002 (HMO-POS) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. While some transportation services are covered under the plan, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Humana Gold Plus H5377-002 (HMO-POS) 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 require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H5377-002 (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist, mental health, psychiatric, and opioid treatment services require a $35 copay and no coinsurance. Physical and occupational therapy have a $25 copay and no coinsurance, but podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Humana Gold Plus H5377-002 (HMO-POS) features partially covered preventive services, providing annual physical exams, kidney disease education, and select screenings with no copay and no coinsurance. Additional benefits such as fitness programs, health education, weight management, and in-home support services are not covered under this plan.
Hearing Services See details
Humana Gold Plus H5377-002 (HMO-POS) covers hearing exams with a $35 copay and no coinsurance for Medicare-covered benefits, and no copay or coinsurance for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $199 to $499, while OTC hearing aids and 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 H5377-002 (HMO-POS) with no deductibles and no coinsurance. Routine eye exams and eyewear—including contact lenses and eyeglasses (lenses and frames)—are available with no copay up to a $250 annual limit, while other eye exams, standalone eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H5377-002 (HMO-POS) up to a $1,750 annual maximum, with a $35 copay and no coinsurance for Medicare-covered services and no copay and no coinsurance for most other preventive and comprehensive services. Under this plan, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H5377-002 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Humana Gold Plus H5377-002 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Humana Gold Plus H5377-002 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay, with prior authorization required. Covered diabetic supplies have a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Humana Gold Plus H5377-002 (HMO-POS), with prior authorization required for most services. Diagnostic procedures and lab services have no coinsurance, featuring no copay for lab services and a $0 to $120 copay for diagnostic tests. Outpatient X-rays have no copay, diagnostic radiology has a minimum $0 copay and no coinsurance, and therapeutic radiology requires a minimum $35 copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H5377-002 (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Gold Plus H5377-002 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, specific sub-services including standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H5377-002 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H5377-002 (HMO-POS) partially covers other services, offering acupuncture with a $35.00 copay and no coinsurance for up to 20 treatments per year with prior authorization. Over-the-counter (OTC) items, meal benefits, and dual-eligible SNP services are not covered.
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