Humana Gold Plus H5619-184 (HMO)

Humana Gold Plus H5619-184 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Ventura. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Humana Gold Plus H5619-184 (HMO) 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 H5619-184 (HMO).

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 H5619-184 (HMO) offers an Enhanced Alternative prescription drug benefit featuring no prescription drug deductible. During the initial coverage phase, members pay for medications until total drug costs reach $2,100.00. Individuals qualifying for the low-income subsidy can also benefit from reduced Part D premiums. Under this plan, tier 1 preferred generics have no copay at standard pharmacies or through preferred mail, though standard mail carries a $20.00 copay. Tier 2 standard generics require a $47.00 copay, while tier 3 preferred brands and tier 4 non-preferred drugs incur 48% and 33% coinsurance, respectively. After reaching $2,100.00 in yearly out-of-pocket costs, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.

Additional Benefits

The Humana Gold Plus H5619-184 (HMO) plan offers affordable coverage for core medical services, featuring no copay for primary care doctor visits, preventive care, and home health services. For acute inpatient hospital stays, members pay a $410 copay per day for days one through six, with no copay starting on day seven. Outpatient hospital services range from no copay up to a $335 copay, while emergency care has a $130 copay that is waived if you are admitted within 24 hours. Supplemental benefits include dental coverage up to a $1,000 annual limit and routine vision care with no copay up to a $250 annual maximum. Routine hearing exams and over-the-counter hearing aids are also available with no copay, though prescription models require a copay between $699 and $999. Additionally, the plan offers meal benefits, over-the-counter items, and acupuncture treatments with no copay or low copays.