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Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Indiana. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-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 - Diabetes and Heart (HMO C-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. 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 $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 $9150.00 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 - Diabetes and Heart (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs when filled at standard pharmacies or through preferred mail order. Tier 2 generic medications are also highly budget-friendly, costing a $5 copay for a one-month supply or no copay for a three-month supply using preferred mail order. For Tier 3 preferred brand drugs, the plan charges a $47 copay for a one-month supply, with savings available on three-month supplies through preferred mail order for a $94 copay. More expensive medications require coinsurance, including a 48% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs. Choosing preferred mail order delivery is often the most cost-effective way to fill your prescriptions with this plan.
Additional Benefits
The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive medical coverage with no copay for primary care visits, home health services, and routine preventive care. For specialized medical care, members pay a $45 copay for specialist visits, while emergency room services require a $115 copay that is waived if admitted. Inpatient hospital stays feature a $405 daily copay for the first several days with no copay for subsequent days, and outpatient hospital services range from no copay up to a $395 copay. This plan also features robust supplemental benefits, including routine dental care up to a $2,000 annual limit, routine vision exams, and routine hearing exams all with no copay. Essential healthcare needs like laboratory tests and home infusion services are also covered with no copay, while diabetic equipment and dialysis require a 20% coinsurance. Additionally, skilled nursing facility stays have no copay for the first 20 days, and over-the-counter items and meals are provided at no cost.
Inpatient Hospital See details
Inpatient hospital services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no coinsurance, requiring a daily copay of $405 for days 1 to 6 for acute stays and days 1 to 5 for psychiatric stays, with no copay for subsequent days. While unlimited additional acute days are covered at no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $395 for outpatient hospital services and $405 per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance. Prior authorization is required for these covered services.
Partial Hospitalization See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP), which features a $335 copay and no coinsurance for ground and air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay 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 each carry a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Other covered benefits, including physical therapy, mental health, and telehealth services, require copays ranging from no copay up to $45 and no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) provides preventive services with no copay and no coinsurance for covered options like annual physical exams, kidney disease education, and a memory fitness benefit. Additional preventive services are only partially covered, with health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs not covered.
Hearing Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers Medicare-covered hearing exams with a $45 copay and no coinsurance, while routine annual exams and fittings have no copay or coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $999, though inner ear, outer ear, and over the ear models are not covered. Over-the-counter (OTC) hearing aids are also fully covered with no copay or coinsurance.
Vision Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) provides partially covered vision services with no coinsurance, featuring routine eye exams with no copay (other exams have a $0 to $45 copay) and up to $200 yearly for eyewear with no copay. Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers Medicare-covered dental services for a $45.00 copay and no coinsurance, and other dental services up to a $2,000 annual limit with no copay and no coinsurance. This benefit is partially covered, as fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance of 0% to 20%, with insulin specifically requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP), including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with a 20% coinsurance and no copay. Prior authorization is required for most of these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures have no coinsurance and a copay ranging from no copay to $105, while lab services and outpatient X-rays have no copay or coinsurance. Diagnostic radiological services have a copay starting at no copay, while therapeutic radiological services require a minimum 20% coinsurance and a $45 copay.
Home Health Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers certain cardiac rehabilitation services with no coinsurance and a $10 copay, though prior authorization is required. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services covered by Humana Gold Plus - Diabetes and Heart (HMO C-SNP) include acupuncture with a $45 copay and no coinsurance, limited to 20 treatments per year with prior authorization required. Over-the-counter items and meal benefits are also covered with no copay and no coinsurance, while other unspecified supplemental services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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* 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.
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