Humana Gold Plus SNP-DE H1951-056 (D-SNP HMO), Washington Parish, LA
Humana Gold Plus SNP-DE H1951-056 (Plan ID: H1951-056) is a 2023 Medicare Special Needs Plan (D-SNP) for people who live in Washington Parish, Louisiana. This Humana HMO plan is required to provide all of the same benefits as Original Medicare and includes some additional benefits, but out-of-pocket costs may be different.
CMS rated this plan 5.0 (Excellent) out of 5 stars.
GET NOTIFIED: 2024 Medicare Special Needs Plan Notification.
What You Need to Know
- Humana Gold Plus SNP-DE H1951-056 is a HMO health plan for dual-eligible (Medicare and Medicaid) beneficiaries.
- This is not a zero-dollar D-SNP cost-sharing plan. Members have small copays on some Medicare-approved healthcare services.
- To qualify, you must have both Medicare Part A and Part B, you must live in the plan's service area (Washington Parish), and you must qualify for full Medicaid.
- It includes prescription drug coverage (Medicare Part D).
- The annual Part D deductible is $505.00. You pay this amount before cost-sharing begins.
- People who qualify for Medicare "Extra Help," can get additional assistance to help pay their Medicare Part D monthly premium, deductible, and copayments.
- The plan offers the same health insurance benefits as Original Medicare and some additional benefits that Original Medicare does not cover.
- If you don't qualify to join Humana Gold Plus SNP-DE H1951-056, you might want to compare Medicare Advantage plans available in Washington Parish, Louisiana. Another popular option is to add one of the many Medicare supplements available in Louisiana and a stand-alone prescription drug plan.
- 2024 costs and benefits for Humana Gold Plus SNP-DE H1951-056 will be available in early October. Get Notification.
| H1951-056-0 Plan Basics | |
|---|---|
| Plan ID: | H1951-056-0 |
| Plan Type: | D-SNP |
| Network Type: | HMO |
| Plan Year: | 2023 |
| Premium: | $38.40/mo Plus your Part B premium. |
| Health Plan Deductible: | $0.00 |
| Out-of-Pocket Maximum: | $7,550 In-network |
| Drug Plan Benefit: | Basic $505.00 deductible |
| Rx Gap Coverage: | No |
| Supplemental Benefits: | Dental, Vision, Hearing |
| Availability: | Washington Parish, LA |
| Insured By: | Humana |
Health Plan Costs & Benefits
Humana Gold Plus SNP-DE H1951-056 is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Humana Gold Plus SNP-DE H1951-056 does allow out-of-network care for emergencies and out-of-area dialysis.
Premiums, deductibles, and copays vary widely from plan to plan. It is very important to compare costs and apply them to your personal financial and healthcare needs.
Monthly Premium
Humana Gold Plus SNP-DE H1951-056's total monthly premium in Washington Parish is $38.40. This includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium.
Annual Deductible
Humana Gold Plus SNP-DE H1951-056's annual health plan deductible is $0.00. This does not include the deductible for the prescription drug plan (if any), which is detailed below.
Maximum Out-of-Pocket Limit
The Maximum Out-of-Pocket (MOOP) with this Humana plan is $7,550 in-network. Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket (MOOP) limit on inpatient and outpatient healthcare services. Once you reach this amount of spending on your copayments, all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year. MOOP does not include monthly premiums, prescriptions, or other extra benefits.
Health Plan Out-of-Pocket Costs
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Humana plan:
| Healthcare Service | Member Cost |
|---|---|
| Health plan deductible | $0 |
| Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) | $7,550 In-network |
| Doctor Visits | |
| Primary | $0 copay |
| Wellness programs (e.g., fitness, nursing hotline) | Covered |
| Preventive care | $0 copay |
| Mental Health Services | |
| Outpatient individual therapy visit with a psychiatrist | $0 or $30 copay (authorization required) |
| Outpatient individual therapy visit | $0 or $30 copay (authorization required) |
| Outpatient group therapy visit | $0 or $30 copay (authorization required) |
| Outpatient group therapy visit with a psychiatrist | $0 or $30 copay (authorization required) |
| Rehabilitation Services | |
| Occupational therapy visit | 0% or 20% coinsurance (authorization required) |
| Medical Equipment / Supplies | |
| Diabetes supplies | $0 copay or 20% coinsurance per item (authorization required) |
| Prosthetics (e.g., braces, artificial limbs) | 0% or 20% coinsurance per item (authorization required) |
| Diagnostic Procedures / Lab Services / Imaging | |
| Outpatient x-rays | $0 or $0-45 copay or 20% coinsurance (authorization required) |
| Diagnostic tests and procedures | $0 or $0-45 copay or 20% coinsurance (authorization required) |
| Diagnostic radiology services (e.g., MRI) | $0 copay or 20% coinsurance (authorization required) |
| Medicare Part B Drugs | |
| Chemotherapy | 0% or 20% coinsurance (authorization required) |
| Foot Care (podiatry Services) | |
| Routine foot care | $0 copay (authorization required, limits may apply) |
| Hearing | |
| Fitting/evaluation | $0 copay (authorization required) |
| Hearing aids | $0 copay (limits may apply) |
| Preventive Dental | |
| Cleaning | $0 copay (limits may apply) |
| Oral exam | $0 copay (limits may apply) |
| Dental x-ray(s) | $0 copay (limits may apply) |
| Comprehensive Dental | |
| Restorative services | $0 copay (authorization required, limits may apply) |
| Endodontics | $0 copay (authorization required, limits may apply) |
| Extractions | $0 copay (authorization required, limits may apply) |
| Diagnostic services | $0 copay (authorization required, limits may apply) |
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay (authorization required, limits may apply) |
| Periodontics | $0 copay (authorization required, limits may apply) |
| Vision | |
| Contact lenses | $0 copay (authorization required, limits may apply) |
| Routine eye exam | $0 copay (authorization required, limits may apply) |
| Other | Not covered |
| Eyeglass frames | Not covered |
| Upgrades | Not covered |
| Eyeglasses (frames and lenses) | $0 copay (authorization required, limits may apply) |
| Emergency Care / Urgent Care | |
| Urgent care | 0% or 20% coinsurance per visit (always covered) |
| Ground ambulance | 0% or 20% coinsurance |
| Inpatient hospital coverage | $0 or $600 per day for days 1 through 3 $0 per day for days 4 through 90 $0 per day for days 91 and bey |
| Outpatient hospital coverage | $0 copay or 20% coinsurance per visit |
| Skilled Nursing Facility | $0 per day for days 1 through 20 $0 or $188 per day for days 21 through 100 |
| Optional supplemental benefits | No |
Feel free to download our Humana Gold Plus SNP-DE H1951-056 Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
Humana Gold Plus SNP-DE H1951-056 includes an basic benefit Medicare Part D plan (PDP). This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid Services, whereas enhanced benefit plans cover more.
Basic plans typically have less cost-sharing by the plan than plans with an enhanced benefit. But, close to a third of all enhanced plans charge more than the average for preferred brand name drugs, and over 50% charge more for non-preferred brand drugs. For most people, a basic plan is their best bet, due to lower premiums and lower cost-sharing, even if the plan has a deductible.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
| Basic Part D Premium: | $38.40 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $38.40 |
| Part D Premium with Full LIS Assistance: | $0.00 |
| Part D Premium with 75% LIS Assistance: | $9.60 |
| Part D Premium with 50% LIS Assistance: | $19.20 |
| Part D Premium with 25% LIS Assistance: | $28.80 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before Humana begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Humana Gold Plus SNP-DE H1951-056 has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Tier | Preferred | Standard |
|---|---|---|
| $0 copay on all covered generic and brand-name prescriptions. | ||
CMS Rating Marks and Our Review
Each year Medicare rates D-SNP plans, like this one, in nine major categories. These ratings are designed to help you understand the quality of care and service you can expect if you qualify and choose to join Humana Gold Plus SNP-DE H1951-056.
This is one of the rare 5-star Medicare Advantage D-SNP plans available in Louisiana. Staying healthy is the best way to save money on health care, and in MedicareWire's judgement, Humana Gold Plus SNP-DE H1951-056 does a good job keeping its members in top health through preventive care, including screenings, tests, and vaccines. This plan is good at managing its member's chronic (long-term) health conditions. Overall, members say their experience with this Humana D-SNP plan is excellent. When it comes to complaints and changes in performance, this plan gets the highest marks. The plan shines at customer service with an overall excellent mark on this important metric.
| CMS Measure | Star Rating |
|---|---|
| 2023 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How to Qualify to Enroll in
Humana Gold Plus SNP-DE H1951-056
To qualify for enrollment in Humana Gold Plus SNP-DE H1951-056 in Washington Parish, you must be eligible for both Medicare and Medicaid. To be eligible for Medicare, you must be age 65 or older, or have Social Security Disability Insurance for 24 months. To be eligible for Medicaid, your income and assets must be at or below Louisiana's state thresholds.
Before enrolling in Humana Gold Plus SNP-DE H1951-056, or any other dual-eligible SNP, be sure to ask the following questions:
- What costs should I expect to pay out-of-pocket (premiums, deductibles, copayments)?
- Will I be able to use my doctors? Are they in the plan's network?
- Are the plan's in-network providers and facilities in convenient locations?
- Does the plan provide coverage for services I receive from out-of-network providers?
- Do I need a referral to see a specialist?
- Are my medications on the Part D plan's formulary? What if I can't afford my medications?
- What special accommodations does the plan make for persons with disabilities?
- Does the plan offer free meal delivery after a stay in the hospital?
- What help is offered for caregivers? Is adult day care covered?
- Does the plan offer a prepaid card for over the counter medications and covered groceries?
Additional D-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
- Peoples Health Secure Complete
- Peoples Health Secure Health
- Vantage DUAL PLUS
- HumanaChoice SNP-DE H5216-332
- Aetna Medicare Dual Select Plan
Contact Humana
Call 1-855-728-0510 (TTY 711) to speak with a licensed insurance agent (Mon-Fri, 8am-9pm , Sat 8am-8pm EST) and learn more about this Special Needs Plan and other plans on this site. You may also Enroll Online using our safe and secure online enrollment website or take advantage of the following plan resources:
| Plan Website: | http://www.humana.com/medicare |
|---|---|
| Formulay Information: | https://www.humana.com/pharmacy/ |
| Pharmacy Information: | Humana Pharmacy Page |
| Prospective Members: | (800)833-2364 |
| TTY Users: | (711)- |
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.
Citations & References
- Humana, http://www.humana.com/medicare, Last Accessed October 13, 2022
- Medicaid.gov, "Medicaid & CHIP in Louisiana", Last Accessed January 20, 2023
- CMS.gov, "Dual Eligible Special Needs Plans (D-SNPs)", Last Accessed January 20, 2023
- CMS.gov, Landscape Source Files, Last Accessed January 21, 2023
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 21, 2023
- CMS.gov, Plan Benefits Package, Last Accessed January 21, 2023