Medicare Plans

Open Medicare Plan Data.

Humana Dual Select H4939-002 (HMO-POS D-SNP) H4939-002 • 2027 • Elkhart County, IN

CMS Rating: Not yet rated by CMS.
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $150.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Elkhart County, IN
Local Enrollment
555 beneficiaries in Elkhart County
Last update:

Introduction

CMS Plan ID H4939-002 identifies Humana Dual Select H4939-002, a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by Humana. Its provider network is a Health Maintenance Organization with a Point of Service (HMO-POS), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $150.00.

Enrollment in this plan requires you to live in Elkhart County, Indiana. CMS reports 555 beneficiaries enrolled in this plan in Elkhart County. New members can call the plan directly at (888)873-0686 (TTY 711) for assistance.

Eligibility

Humana Dual Select H4939-002 is a Medicare D-SNP plan for dual-eligible beneficiaries (Medicare and Medicaid).

Special Needs Plan Type
Dual-Eligible Special Needs Plan (D-SNP)
Medicare Requirement
Medicare Part A and Part B
Special Needs Requirement
Must qualify for Medicaid
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Elkhart County

Compare this plan with the two most-enrolled HMO-POS D-SNP plans available in Elkhart County, Indiana. Enrollment is based on CMS local enrollment data.

HMO-POS D-SNP plan comparison for Elkhart County, Indiana
Plan Detail Humana Dual Select H4939-002 Humana PathWays Dual Care Humana Gold Plus SNP-DE H4939-003
CMS Plan ID H4939-002-0 H4939-001-0 H4939-003-0
Local Enrollment 555 382 260
Monthly Premium $0.00 $0.00 $4.80
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $9,850.00 $9,850.00 $9,850.00
Part B Giveback Not offered Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist 0% or 20% coinsurance $0 copay $0 copay
Part D Deductible $150.00 $700.00 $700.00
CMS Star Rating Not yet rated Not yet rated Not yet rated
Dental $0 copay $0 copay $0 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $0 copay $0 copay

Plan Benefits

Humana Dual Select H4939-002 has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H4939-002.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H4939-002-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: 0% or 20% coinsurance

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0 or $0-$35 copay, 0% or 20% coinsurance
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $0 or $0-$345 copay, 0% or 20% coinsurance
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: $0 copay, 0% or 20% coinsurance
Diagnostic tests and procedures
In-network: $0 copay, 0% or 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
$0 or $115 copay
Worldwide emergency care
Coming soon
Urgent care
0% or 20% coinsurance
Inpatient hospital care
In-network:
Tier 1
$0 or $2,241 per stay
Skilled Nursing Facility
In-network:
Tier 1
$0 per day for days 1-20
$0 or $221 per day for days 21-100
Ground ambulance
In-network: $0 or $325 copay

Mental Health Services

Outpatient individual therapy
In-network: $0 or $35 copay
Outpatient group therapy
In-network: $0 or $35 copay
Inpatient psychiatric hospital care
In-network:
Tier 1
$0 or $2,241 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: 0% or 20% coinsurance
Occupational therapy
In-network: 0% or 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay, 0% or 20% coinsurance
Durable medical equipment
In-network: 0% or 20% coinsurance
Prosthetics
In-network: 0% or 20% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0% or 0%-20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: $0 copay, 0% or 0%-20% coinsurance

Dental Services

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
Not covered
Eyeglass lenses only
Not covered
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
Not covered

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $0 copay
OTC hearing aids
In-network: $0 copay

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
Not covered

Certain preventive services are covered 100% by Humana Dual Select H4939-002 as a Part B benefit.

Prescription Drug Coverage

Humana Dual Select H4939-002 includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Humana Dual Select H4939-002 (H4939-002-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:($23.50)
Supplemental Part D Premium:$23.50
Total Part D Premium:$0.00
Low-Income Premium Subsidy:$17.02
Low-Income Premium Subsidy Paid by CMS:$0.00
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $150.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Humana starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Humana Dual Select H4939-002 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Humana Dual Select H4939-002 (H4939-002-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copay$0.00 copay
Generic$0.00 copay$0.00 copay
Preferred Brand25% coinsurance25% coinsurance
Non-Preferred Drug25% coinsurance25% coinsurance
Specialty Tier31% coinsurance25% coinsurance
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H4939)

Medicare evaluates plan quality using a star rating system developed by the Centers for Medicare & Medicaid Services (CMS). Ratings are based on measures such as health outcomes, member experience, and customer service, and are reported on a 1 to 5 star scale, with higher ratings indicating stronger overall performance.

2027 Medicare Star Ratings for Contract H4939
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines Plan too new to be measured
Managing Chronic (Long Term) Conditions Plan too new to be measured
Member Experience with Health Plan Plan too new to be measured
Complaints and Changes in Plans Performance Plan too new to be measured
Health Plan Customer Service Plan too new to be measured
Drug Plan Customer Service Plan too new to be measured
Complaints and Changes in the Drug Plan Plan too new to be measured
Member Experience with the Drug Plan Plan too new to be measured
Drug Safety and Accuracy of Drug Pricing Plan too new to be measured
Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Humana (official source) http://www.humana.com/medicare October 4, 2026
CMS.gov Dual Eligible Special Needs Plans (D-SNPs) April 28, 2026
Medicare.gov Compare types of Medicare Advantage Plans April 28, 2026
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You April 28, 2026

MedicarePlans.com is an independent informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.

Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.