A non-government entity
Humana Gold Plus H5619-051 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H5619-051 (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 H5619-051 (HMO-POS) in 2026, please refer to our full plan details page.
Humana Gold Plus H5619-051 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Fort Wayne Metro Area. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H5619-051 (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 H5619-051 (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 H5619-051 (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.
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 $250.00 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 $4500.00 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:
Sign up for Humana Gold Plus H5619-051 (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus H5619-051 (HMO-POS) prescription drug plan features an annual drug deductible of $250. For Tier 1 preferred generic drugs, members pay no copay for one-month or three-month supplies at standard pharmacies and through preferred mail order. Tier 2 generic medications are available for a $5 copay for a one-month supply, with no copay for a three-month supply when filled via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply, with a slightly reduced copay of $131 for a three-month supply through preferred mail order. For higher-tier medications, members pay a coinsurance of 48% for Tier 4 non-preferred drugs and 30% for Tier 5 specialty drugs. This plan offers several opportunities to minimize out-of-pocket prescription costs by utilizing preferred mail order services.
Additional Benefits
The Humana Gold Plus H5619-051 (HMO-POS) offers robust medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. Specialist visits require a $35 copay with no coinsurance, while emergency room services carry a $130 copay that is waived if you are admitted. For hospital care, inpatient stays require a $450 daily copay for the first six days followed by no copay, while outpatient hospital services feature copays ranging from $0 to $450. This plan also includes essential dental, vision, and hearing benefits, offering no copay for routine eye exams, select eyewear up to $100, and preventive dental services up to a $2,000 annual limit. Routine hearing exams also feature no copay, while covered prescription hearing aids require a copay between $699 and $999. Additionally, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H5619-051 (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Medicare-covered acute stays require a $450 daily copay for days 1 through 6 and no copay for days 7 and beyond, while psychiatric stays require a $450 daily copay for days 1 through 5 and no copay for days 6 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital care has a copay ranging from $0 to $450, while outpatient substance abuse sessions require a $35 copay and observation services carry a $450 copay per stay.
Partial Hospitalization See details
Humana Gold Plus H5619-051 (HMO-POS) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H5619-051 (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, psychiatric, and opioid treatments require a $35 copay and no coinsurance. Therapy services feature a $10 to $40 copay with no coinsurance, telehealth ranges from no copay to a $50 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers core preventive services, including annual physical exams and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay or coinsurance, but exclude health education, PERS, weight management, alternative therapies, nutritional/dietary benefits, in-home support, and home modifications.
Hearing Services See details
Humana Gold Plus H5619-051 (HMO-POS) hearing services are partially covered, offering routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are covered up to two per year with a $699 to $999 copay and no coinsurance, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus H5619-051 (HMO-POS), offering no copay and no coinsurance for covered routine eye exams and select eyewear up to a $100 annual limit. Other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H5619-051 (HMO-POS) dental services are partially covered up to a $2,000 annual maximum, with Medicare-covered dental services requiring a $35 copay and no coinsurance. Most preventive and diagnostic services require no copay and no coinsurance, while restorative and fixed prosthodontics have no copay and a 30% to 40% coinsurance; however, fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while insulin has a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus H5619-051 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H5619-051 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers diagnostic and radiological services, featuring no copay for lab services and outpatient X-rays, and no coinsurance for diagnostic tests which carry a $0 to $100 copay. Therapeutic radiological services require a $30 copay and 20% coinsurance, while diagnostic radiological services have a $0 minimum copay, with prior authorization required for all services.
Home Health Services See details
Humana Gold Plus H5619-051 (HMO-POS) covers home health services 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 H5619-051 (HMO-POS) with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a $10 copay.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H5619-051 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not necessary, additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Humana Gold Plus H5619-051 (HMO-POS) partially covers other services, offering acupuncture for a $35 copay and no coinsurance for up to 20 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved