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Humana Gold Plus Chronic Kidney Disease (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Chronic Kidney Disease (HMO C-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 Chronic Kidney Disease (HMO C-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) is a HMO C-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Indiana and Kentucky. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Humana Gold Plus Chronic Kidney Disease (HMO C-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 Chronic Kidney Disease (HMO C-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 Chronic Kidney Disease (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.
For Humana Gold Plus Chronic Kidney Disease (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $615.00 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 $9200.00 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:
Sign up for Humana Gold Plus Chronic Kidney Disease (HMO C-SNP)
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Drug Coverage
The Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan features an annual prescription drug deductible of $615. For initial coverage, members enjoy no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when filled at standard pharmacies or through preferred mail order. Standard mail-order options for these lower tiers carry a modest copay starting at $10 for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply across standard pharmacies and mail-order services, with savings available on three-month supplies through preferred mail order. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 49% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance.
Additional Benefits
The Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan offers comprehensive coverage designed to minimize out-of-pocket expenses, featuring no copay and no coinsurance for essential services like primary care visits, dialysis, and home health care. Specialist visits require a $50 copay, while inpatient hospital stays incur a $450 daily copay for the first few days with no copay thereafter. Emergency care is available with a $115 copay, which is waived upon hospital admission, and routine transportation to approved locations is provided with no copay. Members also benefit from robust supplemental coverage, including no copay for preventive dental, routine vision exams with a $150 allowance for eyewear, and routine hearing exams with no copay. Durable medical equipment and prosthetics are covered with no copays and a 20% coinsurance. Additionally, the plan includes valuable extras such as over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) with no coinsurance, featuring a $450 daily copay for days 1 to 5 for acute stays (no copay for days 6 and beyond) and a $450 daily copay for days 1 to 4 for psychiatric stays (no copay for days 5 to 90). Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $435, plus a $450 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require a $35 copay per session and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers partial hospitalization with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers ground and air ambulance services with a $315 copay and no coinsurance. Transportation services are partially covered with no copay and no coinsurance for unlimited one-way trips to plan-approved locations, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency services are covered by Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) primary care benefits include primary care physician visits with no copay and no coinsurance, and specialist visits for a $50 copay and no coinsurance. Other covered services like physical therapy, mental health, and podiatry have copays ranging from $5 to $50 with no coinsurance, though chiropractic services are not covered in practice.
Preventive Services See details
Preventive services are covered by Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and select screenings. However, additional preventive benefits are only partially covered, offering a memory fitness benefit with no copay and no coinsurance, but excluding health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, extra smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) offers hearing services with no coinsurance, featuring a $30 copay for Medicare-covered exams and no copay for routine exams, fittings, and OTC hearing aids. Prescription hearing aids are partially covered with no coinsurance and copays between $399 and $999 for up to two devices per year, though inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are partially covered under the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) plan with no coinsurance, no deductibles, and copays ranging from $0 to $50, with prior authorization required. Covered benefits include one annual routine eye exam with no copay and a $150 annual maximum for one pair of eyeglasses (lenses and frames) or contact lenses with no copay, while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers dental services with a $50 copay and no coinsurance for Medicare-covered care, and no copay or coinsurance for other covered preventive and comprehensive services up to a $1,500 annual maximum. This benefit is partially covered, as fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs carry a coinsurance ranging from no coinsurance to 20%, with insulin requiring a $35 copay and other drugs requiring no copay.
Dialysis Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers dialysis services with no copay and no coinsurance. Prior authorization is required to access this benefit.
Medical Equipment See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copays and a 20% coinsurance. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) with prior authorization required. Members pay no copay for lab services or outpatient X-rays, copays ranging from $0 to $105 with no coinsurance for diagnostic procedures, and a minimum 20% coinsurance with copays starting at $0 for therapeutic radiological services.
Home Health Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) indicates that some services are covered with no coinsurance and require prior authorization, but in practice, key rehabilitation services are not covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a $10 copay.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services covered by the Humana Gold Plus Chronic Kidney Disease (HMO C-SNP) include acupuncture, which requires a $50 copay and no coinsurance for up to 20 treatments per year. Over-the-counter (OTC) items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for meals and acupuncture, and some other services are not covered.
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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