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 Virginia. This plan received an overall rating of 3.5 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) plan features an annual drug deductible of $450, but offers significant savings on many common medications. There is no copay for Tier 1 preferred generic drugs at standard pharmacies and preferred mail-order services, and Tier 6 select care drugs also feature no copay across all pharmacy and mail-order options. Tier 2 generic drugs are highly affordable, costing a $5 copay for a one-month supply at standard pharmacies or no copay for a three-month supply through preferred mail order. For higher-tier medications, Tier 3 preferred brands carry a $47 copay for a one-month supply, though you can save on a three-month supply with a $94 copay through preferred mail order. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs have a 27% coinsurance across all pharmacy options. Understanding these copays and coinsurance rates helps you maximize your benefits and minimize your out-of-pocket prescription costs.

Additional Benefits

The Humana Gold Plus - Diabetes and Heart (HMO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, home health care, and cardiac rehabilitation. For hospital stays, members pay a $375 daily copay for the first few days of inpatient care and no copay for the remaining days, while specialist visits require a $50 copay. Emergency services are available with a $115 copay, which is waived if you are admitted, and urgent care has a $40 copay with no coinsurance. This plan also includes valuable supplemental benefits with no copay or coinsurance for routine hearing exams, annual eye exams, and up to $200 for eyewear. Preventive and comprehensive dental services are covered up to a $500 yearly limit with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Prescription hearing aids are partially covered with copays ranging from $299 to $599, ensuring affordable access to essential medical devices and routine care.