Humana Gold Plus SNP-DE H5619-162 (HMO-POS D-SNP)

Humana Gold Plus SNP-DE H5619-162 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in West Virginia. 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 H5619-162 (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 H5619-162 (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 H5619-162 (HMO-POS D-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for a one-month or three-month supply at standard pharmacies and through preferred mail order. Standard mail order for these generic tiers requires a copay, ranging from $10 to $30 for Tier 1 and $20 to $60 for Tier 2. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a 25% coinsurance. This 25% coinsurance rate applies across standard pharmacies, preferred mail order, and standard mail order services. These consistent coinsurance rates help you easily plan for your brand-name and specialty prescription costs.

Additional Benefits

The Humana Gold Plus SNP-DE H5619-162 (HMO-POS D-SNP) offers robust healthcare coverage, featuring no copay and a 20% coinsurance for primary care visits, outpatient hospital services, and durable medical equipment. For hospitalizations, members pay no coinsurance but face a copay of $2,230 per stay for acute inpatient care and $2,080 for psychiatric care. Emergency room visits carry a $115 copay, which is waived upon admission, while preventive care and home health services are covered with no copay and no coinsurance. Supplemental benefits further enhance this plan, providing dental care up to a $4,000 annual limit and eyewear up to a $550 annual allowance, both with no copay or coinsurance. Routine hearing exams, fitting evaluations, and hearing aids are also covered with no copay, though some coinsurance applies to the exams. Additionally, the plan covers up to 48 one-way transportation trips to approved locations with no copay or coinsurance and offers skilled nursing facility stays with no copay for the first 20 days.