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Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H8908-007 (HMO D-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 SNP-DE H8908-007 (HMO D-SNP) in 2025, please refer to our full plan details page.
Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) is a HMO D-SNP 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 SNP-DE H8908-007 (HMO D-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 SNP-DE H8908-007 (HMO D-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 SNP-DE H8908-007 (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.
For Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $590.00 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 $9350.00 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 SNP-DE H8908-007 (HMO D-SNP) plan has a $590.00 deductible for prescription drugs. After you pay the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. If you qualify for the low-income subsidy (LIS), your monthly Part D premium will be $26.60. Once your yearly out-of-pocket drug costs reach $2000.00, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and primary care services have coinsurance. Emergency services and ambulance services have copays, and transportation services are available with no copay. Preventive services, hearing exams, eye exams, and many dental services have no copay, while other services like vision and dental services involve coinsurance. The plan also covers home health services and skilled nursing facility stays with copays for some days. Additionally, the plan covers home infusion services, dialysis services, medical equipment, and diagnostic and radiological services with varying coinsurance and copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, with prior authorization required. For Inpatient Hospital-Acute, you will pay a copay of $2,185 per admission or stay, and for Inpatient Hospital Psychiatric, the copay is $2,036 per admission or stay.
Outpatient Services See details
Outpatient services include outpatient hospital services and observation services, both of which have a 20% coinsurance, as well as ambulatory surgical center services and outpatient substance abuse services that have a minimum 20% coinsurance and a maximum 20% coinsurance. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $315 copay, and transportation services with no copay. Transportation services to any health-related location are limited to 76 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan. Emergency Services have a $110 copay, Urgently Needed Services have 20% coinsurance, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. You will pay 20% coinsurance for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Routine Chiropractic Care has no copay, and a $0 copay for Additional Telehealth Benefits.
Preventive Services See details
Preventive Services include annual physical exams with no copay, as well as additional preventive services, kidney disease education services, and other preventive services, all of which have no copay. This plan also covers wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, and fitness benefits with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, 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, 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
Hearing services include hearing exams with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with no copay for 2 visits every three years, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan covers vision services, including eye exams with no copay and 20% coinsurance, and eyewear with 20% coinsurance. Eyeglasses (lenses and frames) and contact lenses are covered with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a $5,000 annual maximum for other dental services. Medicare Dental Services have a 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay, while fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance and no copay. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan and require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment are covered. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have a 20% coinsurance with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a coinsurance of at most 20%, and lab services with no copay and a coinsurance of at most 20%. Diagnostic radiological services have a copay of at most $325 and a coinsurance of at most 20%, while outpatient X-ray services have a $50 copay and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered 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 the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan. There is no copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Gold Plus SNP-DE H8908-007 (HMO D-SNP) plan covers acupuncture with 20% coinsurance after prior authorization, and a meal benefit with no copay after prior authorization. Over-the-counter (OTC) items are covered up to $1800.00 per year. The plan does not cover Dual Eligible SNPs with Highly Integrated Services, and several other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services.
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