Humana Gold Plus SNP-DE H5619-166 (HMO D-SNP)

Humana Gold Plus SNP-DE H5619-166 (HMO D-SNP) is a HMO D-SNP plan offered by Arcadian Health Plan, Inc. available for the 2026 plan year to people living in Select Counties in WA. 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 H5619-166 (HMO 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 H5619-166 (HMO 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 H5619-166 (HMO D-SNP) has an annual drug deductible of $235. For Tier 1 preferred generics and Tier 2 generics, there is no copay for one-month and three-month supplies at standard pharmacies and preferred mail order. If you use standard mail order, you will pay a $10 copay for Tier 1 and a $20 copay for Tier 2 one-month supplies. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs require a 25% coinsurance for both one-month and three-month supplies across standard pharmacies and mail-order options. Specialty medications in Tier 5 carry a 30% coinsurance for a one-month supply at standard pharmacies and mail-order services.

Additional Benefits

The Humana Gold Plus SNP-DE H5619-166 (HMO D-SNP) offers comprehensive coverage with predictable cost-sharing, generally featuring no copay and a 20% coinsurance for outpatient care, primary and specialist visits, dialysis, and durable medical equipment. For inpatient hospital stays, members pay a set copay per stay with no coinsurance, while emergency services require a $115 copay with no coinsurance. Additionally, home health services, preventive care, and up to 24 one-way transportation trips are fully covered with no copay and no coinsurance. Supplemental benefits under this plan include routine dental care up to a $2,000 annual maximum, as well as over-the-counter hearing aids and routine vision hardware, all available with no copay and no coinsurance. Routine hearing and vision exams are also covered with no copay and a 20% coinsurance. Finally, skilled nursing facility stays require no coinsurance and feature no copay for the first 20 days, though a daily copay applies for days 21 through 65.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.