Humana Gold Plus - Diabetes and Heart (HMO C-SNP)

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 South Carolina. 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.

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.

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 - Diabetes and Heart (HMO C-SNP) prescription drug plan has an annual drug deductible of $450. Beneficiaries can save on everyday medications with no copay for Tier 1 preferred generics at standard pharmacies and preferred mail order, as well as no copay for Tier 6 select care drugs across all pharmacy options. Tier 2 generic drugs carry a low $5 copay for a one-month supply, which drops to no copay for a three-month supply filled through preferred mail order. For advanced medication needs, Tier 3 preferred brand drugs require a $47 copay for a one-month supply. High-tier medications require coinsurance instead of a flat copay, with Tier 4 non-preferred drugs requiring 48% coinsurance and Tier 5 specialty drugs requiring 27% coinsurance. Choosing preferred mail order can provide additional savings on select multi-month prescription supplies.

Additional Benefits

The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive coverage designed to minimize out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, home health services, and preventive care. For specialized medical needs, the plan requires a $40 copay for specialist visits and a $375 daily copay for the first seven days of acute inpatient hospital stays, followed by no copay for additional days. Diagnostic services like lab tests and outpatient X-rays are also fully covered with no copay or coinsurance. Members also benefit from robust supplemental coverage, including no copay or coinsurance for routine vision exams and eyewear up to a $250 annual limit, as well as preventive and comprehensive dental care up to $1,250 yearly. Routine hearing exams and over-the-counter hearing aids are available with no copay, while prescription hearing aids require copays ranging from $199 to $799. Additionally, the plan covers over-the-counter items with no copay, helping you manage daily health expenses affordably.