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Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H5619-156 (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 SNP-DE H5619-156 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Humana Gold Plus SNP-DE H5619-156 (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 SNP-DE H5619-156 (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 SNP-DE H5619-156 (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 SNP-DE H5619-156 (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 SNP-DE H5619-156 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $48.60. 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 $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:
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Drug Coverage
The Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs, but the specific amounts for each drug tier are not listed in this summary. Once your total drug costs reach $2000.00, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly Part D premium is $48.60. Once your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays and coinsurance. Many services have a 20% coinsurance, while others, like preventative services and some vision and dental services, have no copay. This plan provides coverage for hearing, vision, and dental services, and also includes benefits for ambulance, emergency, and home health services. Additional benefits include coverage for home infusion services, dialysis, and medical equipment. This plan also covers other services like acupuncture and over-the-counter items, with certain limitations.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute, there is a copay of $2185 per admission or stay for a Medicare-covered stay and no copay for additional days. For Inpatient Hospital Psychiatric, there is a copay of $2036 per admission or stay for a Medicare-covered stay.
Outpatient Services See details
Outpatient Services include outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services and observation services have a 20% coinsurance, while ambulatory surgical center services and outpatient substance abuse services have a 20% coinsurance. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay and cover up to 50 one-way trips per year via taxi, bus/subway, or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under this plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, and Urgently Needed Services has a 20% coinsurance.
Primary Care See details
The Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services with a 20% coinsurance for most services. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and additional preventive services for which you will need to see more copay information. Additionally, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit all have no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees are not covered.
Hearing Services See details
Hearing exams and prescription hearing aids are covered by the Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan, with routine hearing exams and fitting/evaluation for hearing aids having no copay and a 20% coinsurance, and prescription hearing aids having no copay, and a maximum benefit of $1500 per year. OTC hearing aids are not covered, and inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a 20% coinsurance and no copay, as well as eyewear benefits. Eyewear benefits include contact lenses with no copay, eyeglasses (lenses and frames) with no copay, and a combined maximum of $400.00 per year, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan covers Medicare dental services with 20% coinsurance and other dental services up to a $3,500 maximum per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services have no copay, and restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Fluoride treatment, maxillofacial prosthetics, implant services, 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. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance, and requires prior authorization.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), prosthetics, medical supplies, and diabetic equipment, is covered. DME has a 20% coinsurance and no copay, while Prosthetic Devices and Diabetic Supplies have a 20% coinsurance with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, tests, and lab services, are covered. Diagnostic procedures and tests have a coinsurance of at most 20%, while lab services have a $0 copay and a coinsurance of at most 20%. Diagnostic, therapeutic, and outpatient X-ray services all have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan 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 by the Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the "Other Services" benefit, acupuncture is covered with a 20% coinsurance, and a limit of 20 treatments per year. This plan also covers over-the-counter (OTC) items, with a maximum benefit coverage amount of $1260 per year, and offers a meal benefit with no copay.
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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