Humana Gold Plus SNP-DE H5619-123 (HMO-POS D-SNP)

Humana Gold Plus SNP-DE H5619-123 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Arkansas. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Humana Gold Plus SNP-DE H5619-123 (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.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Humana Gold Plus SNP-DE H5619-123 (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.

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:

Drug Coverage

The Humana Gold Plus SNP-DE H5619-123 (HMO-POS D-SNP) features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00, which may be reduced to $0 for those qualifying for the low-income subsidy. During the initial coverage phase, Tier 1 preferred generic drugs are available with no copay at standard pharmacies and through preferred mail, while standard mail delivery has a $20.00 copay. For Tier 2 standard generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance at standard pharmacies, standard mail, and preferred mail. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescriptions.

Additional Benefits

The Humana Gold Plus SNP-DE H5619-123 (HMO-POS D-SNP) plan provides coverage for inpatient hospital stays with a $2,230 copay for acute care and a $2,080 copay for psychiatric care per stay, both with no coinsurance. For many everyday healthcare needs, including primary care, specialist visits, outpatient services, and medical equipment, members typically pay a 20% coinsurance with no copay. Emergency room visits carry a $115 copay, which is waived if you are admitted, while urgently needed care requires a 20% coinsurance with no copay. Preventive care, home health services, and meal benefits are fully covered with no copays or coinsurance. The plan also includes valuable supplemental benefits, such as dental coverage up to a $3,000 annual limit with no copay or coinsurance, and a $300 annual eyewear allowance. Furthermore, skilled nursing facility stays feature no copay for the first 20 days, and members can access up to 60 free one-way trips per year to approved health-related locations.