Humana Gold Plus H5619-148 (HMO)

Humana Gold Plus H5619-148 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Central/Southern California Area. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Humana Gold Plus H5619-148 (HMO) 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 H5619-148 (HMO).

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 H5619-148 (HMO) plan features an Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. Beneficiaries who qualify for the low-income subsidy, also known as Extra Help, will pay no copay for their Part D coverage. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. During the initial coverage phase, a 30-day supply of Tier 1 preferred generic drugs carries a $5.00 copay at standard pharmacies and preferred mail, or a $20.00 copay via standard mail. Tier 2 standard generic drugs require a $47.00 copay, while Tier 3 preferred brands carry a 43% coinsurance. Tier 4 non-preferred drugs require a 25% coinsurance at standard pharmacies and mail order services.

Additional Benefits

The Humana Gold Plus H5619-148 (HMO) plan offers robust medical coverage with no copay and no coinsurance for primary care, specialist visits, preventive care, and home health services. Hospitalization benefits feature no coinsurance, requiring a $150 copay for days 1 through 5 of inpatient acute care and a $150 copay for emergency room visits. Outpatient surgery, lab services, and diagnostic X-rays are also highly affordable, with no copay required for most of these services. This plan provides valuable dental, vision, and hearing benefits, featuring no copay or coinsurance for routine exams and preventative care up to set annual limits. Prescription hearing aids are covered with a copay of $299 to $899, while skilled nursing facility stays require daily copays starting at $20 for the first 20 days. Additionally, durable medical equipment and dialysis services are covered with no copay, requiring a 15% and 20% coinsurance, respectively.