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Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS 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 Integrated SNP-DE H5619-054 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Indiana. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS 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 Integrated SNP-DE H5619-054 (HMO-POS 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 Integrated SNP-DE H5619-054 (HMO-POS 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 Integrated SNP-DE H5619-054 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.10. 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 $590.00 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 $9350.00 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 Integrated SNP-DE H5619-054 (HMO-POS D-SNP)
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Drug Coverage
The Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, your premium is $39.10.
Additional Benefits
The Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services, partial hospitalization, and many other services, like primary care, have a 20% coinsurance. Some services, such as preventive care, hearing exams, vision exams, dental services, and home health services, have no copay. The plan also includes coverage for ambulance and transportation services, emergency services, and various therapies. Additionally, the plan covers medical equipment, diagnostic and radiological services, and skilled nursing facility stays. Other benefits include acupuncture, over-the-counter items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, the copay is $2,185 per admission or stay, and additional days have no copay. Inpatient Hospital Psychiatric has a copay of $2,036 per admission or stay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while ASC services and outpatient substance abuse services have a 20% coinsurance. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a 20% coinsurance, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and Air Ambulance Services have a $315 copay, and Transportation Services have no copay.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by this plan. Emergency Services have a $110 copay, while Urgently Needed Services have a 20% coinsurance and Worldwide Emergency Services have a $110 copay.
Primary Care See details
Primary Care, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with a 20% coinsurance. Chiropractic Services are covered with a 20% coinsurance and Routine Chiropractic Care has no copay. Podiatry Services are covered with a 20% coinsurance and Medicare-covered Podiatry Services have no copay. Occupational Therapy Services have 20% coinsurance.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while additional preventive services and kidney disease education services have a copay; some other services are not covered. Additional sessions of smoking and tobacco cessation counseling and fitness benefits are also covered with no copay.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams and no copay for Medicare-covered benefits. Prescription hearing aids are covered, with no copay for all types of hearing aids. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with no copay and 20% coinsurance, and eyewear. Eyewear includes contact lenses with no copay and 20% coinsurance, and eyeglasses (lenses and frames) with no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered. The plan has a combined maximum of $550 for all eyewear every year.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance and other dental services with a $6,000 maximum benefit each year. Oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, implant services, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay; however, fluoride treatment, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance and no copay. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment are covered. Durable Medical Equipment has a 20% coinsurance and Diabetic Supplies have a 20% coinsurance, with no copay. Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts also have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests have a coinsurance of at most 20%, while Lab Services have a coinsurance of at most 20% and no copay. Diagnostic Radiological Services have a copay of at most $325 and a coinsurance of at most 20%, and Outpatient X-Ray Services have a $50 copay and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the following sub-services: Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. There is a coinsurance for the covered services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with a $0 copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has no copay and is limited to 25 treatments per year, while OTC items have a maximum coverage amount of $2700 per year, and the meal benefit has no copay. The plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services.
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