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Humana Gold Plus H8908-004 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H8908-004 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H8908-004 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus H8908-004 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Detroit Metro Area. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H8908-004 (HMO-POS) 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 H8908-004 (HMO-POS).
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 H8908-004 (HMO-POS), 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. Additionally, this plan comes with a Part B Premium reduction of $3.00. You must continue to pay paying your reduced 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 $250.00 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 $4600.00 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:
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Drug Coverage
The Humana Gold Plus H8908-004 (HMO-POS) plan has a $250 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you will pay a $5 copay for preferred generic drugs at a standard or mail-order pharmacy, and 43% coinsurance for preferred brand drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs.
Additional Benefits
The Humana Gold Plus H8908-004 (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have a copay that varies depending on the service. The plan includes coverage for primary care with no copay, and specialist visits with a $40 copay. Preventive services, including an annual physical exam, are covered with no copay. The plan also includes coverage for hearing, vision, and dental services with varying costs, as well as home health services with no copay. Emergency services have a $125 copay, and ambulance services have a $315 copay.
Inpatient Hospital See details
Inpatient hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $440 copay for days 1-6, and no copay for days 7-90, and for Inpatient Hospital Psychiatric, you pay a $440 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered under the Humana Gold Plus H8908-004 (HMO-POS) plan, with coverage including all outpatient hospital services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $440, and observation services have a $440 copay, while Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a copay between $40 and $95.
Partial Hospitalization See details
Partial hospitalization is covered by the Humana Gold Plus H8908-004 (HMO-POS) plan, but requires prior authorization. The copay for partial hospitalization is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $315 copay for both ground and air ambulance services, and no copay for transportation services to a plan-approved health-related location. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Gold Plus H8908-004 (HMO-POS) plan. Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a $55 copay and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $125 copay.
Primary Care See details
The Humana Gold Plus H8908-004 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $10 copay, and occupational therapy services with a copay between $10 and $40. This plan also covers physician specialist services with a $40 copay, and individual and group mental health and psychiatric sessions with a $40 copay. Physical therapy and speech-language pathology services have a copay between $10 and $40, and additional telehealth benefits have a copay between $0 and $55. Opioid treatment program services are covered with a copay between $40 and $95.
Preventive Services See details
Preventive Services are covered, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, are covered with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The Humana Gold Plus H8908-004 (HMO-POS) plan covers hearing exams with a $40 copay, and routine hearing exams with no copay for one visit every year. The plan also covers fitting/evaluation for hearing aids with no copay and OTC hearing aids up to $60 every three months. Prescription hearing aids are partially covered, with a copay between $599 and $899 for all types, but not for inner, outer, or over-the-ear hearing aids.
Vision Services See details
The Humana Gold Plus H8908-004 (HMO-POS) plan covers vision services, including routine eye exams with a copay of $0, and eyewear with a copay of $0 and a combined maximum of $150 per year for contact lenses and eyeglasses (lenses and frames); however, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H8908-004 (HMO-POS) plan covers dental services, including oral exams, dental X-rays, other diagnostic services, cleaning, and other preventive services with no copay, but fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered. Restorative services and fixed prosthodontics have a 30-40% coinsurance, and Oral and Maxillofacial Surgery has no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H8908-004 (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the Humana Gold Plus H8908-004 (HMO-POS) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetic Devices and Medical Supplies also have a 20% coinsurance; Diabetic Supplies have between a 10% and 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, and lab services, are covered by this plan. Lab services have no copay, while diagnostic procedures/tests have a copay between $0 and $95. Radiological services, including diagnostic and therapeutic radiological services and outpatient X-rays, are also covered. Outpatient X-rays have no copay, while diagnostic radiological services have a copay up to $720, and therapeutic radiological services have 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H8908-004 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but there is no information about the copay or coinsurance. However, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H8908-004 (HMO-POS) plan with a copay of $10 for days 1-20 and $214 for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for Skilled Nursing Facility (SNF) are not covered.
Other Services See details
Other Services include acupuncture with a $40 copay, over-the-counter items with a $60 maximum benefit, and meal benefits with no copay; however, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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