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Humana Gold Plus - Diabetes and Heart (HMO C-SNP) Medicare Special Need Plan H1036-302 • 2027

CMS Rating: ☆☆☆☆☆ (4.5 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$3300.00In-network
Part B Giveback
−$109.00 reduction
Prescription Coverage
Enhanced, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
4,260 beneficiaries
Last update:

Introduction

Humana Gold Plus - Diabetes and Heart is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Humana. The plan uses a Health Maintenance Organization (HMO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $0.00 monthly premium, $0.00 medical deductible, and $3300.00 in-network maximum out-of-pocket. CMS Plan ID H1036-302 identifies this plan. The 2027 Part D prescription drug deductible is $700.00.

CMS reports 4,260 beneficiaries enrolled across all service areas. You must live in the plan's service area to enroll: See List.

Eligibility

Humana Gold Plus - Diabetes and Heart is a Medicare C-SNP plan for individuals with specific chronic or disabling conditions.

Special Needs Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Medicare Requirement
Must have Medicare Part A and Part B
Special Needs Requirement
This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes mellitus.
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Plan Benefits

Humana Gold Plus - Diabetes and Heart 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 H1036-302.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $0 copay In-network: $0 copay
Specialist In-network: $20 copay In-network: $20 copay

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay In-network: $0 copay
Telehealth benefit In-network: $0-$20 copay In-network: $0-$20 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon In-network: $0 copay
Health education Not covered Not covered
Counseling services Not covered Not covered
Over-the-counter drug benefits In-network: $0 copay In-network: $0 copay
Health transportation (non-emergency) Coming soon In-network: $0 copay

Diagnostic, Lab, and Imaging Services

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: $0-$250 copay In-network: $0-$250 copay
Lab services In-network: $0 copay In-network: $0-$50 copay
Outpatient x-rays In-network: $0-$125 copay In-network: $0-$125 copay
Diagnostic tests and procedures In-network: $0-$200 copay In-network: $0-$200 copay

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $150 copay $150 copay
Worldwide emergency care Coming soon $150 copay
Urgent care $15 copay $15 copay
Inpatient hospital care Tier 1
$250 per day for days 1-6
$0 per day for days 7-90
$0 per stay		 Tier 1
$250 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Skilled Nursing Facility Tier 1
$0 per day for days 1-20
$160 per day for days 21-100		 Tier 1
$0 per day for days 1-20
$160 per day for days 21-100
Ground ambulance In-network: $0-$260 copay In-network: $0-$260 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $20 copay In-network: $20 copay
Outpatient group therapy In-network: $20 copay In-network: $20 copay
Inpatient psychiatric hospital care Tier 1
$250 per day for days 1-6
$0 per day for days 7-90
$0 per stay		 Tier 1
$250 per day for days 1-6
$0 per day for days 7-90
$0 per stay

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: $25-$40 copay In-network: $25-$40 copay
Occupational therapy In-network: $25-$40 copay In-network: $25-$40 copay

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: $0 copay, 20% coinsurance In-network: $0 copay, 20% coinsurance
Durable medical equipment In-network: $0 copay, 20% coinsurance In-network: $0 copay, 20% coinsurance
Prosthetics In-network: 20% coinsurance In-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: 0%-20% coinsurance In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered) In-network: 0%-20% coinsurance In-network: 0%-20% coinsurance

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam In-network: $0 copay In-network: $0 copay
Dental x-rays In-network: $0 copay In-network: $0 copay
Cleaning In-network: $0 copay In-network: $0 copay
Periodontics In-network: 0%-30% coinsurance In-network: $0 copay
Endodontics Not covered Not covered
Restorative services In-network: 0%-30% coinsurance In-network: $0 copay
Implant services Not covered Not covered
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery In-network: 30% coinsurance In-network: $0 copay

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
Covered Service 2027 2026
Routine eye exam In-network: $0 copay In-network: $0 copay
Contact lenses In-network: $0 copay In-network: $0 copay
Eyeglass frames only Not covered Not covered
Eyeglass lenses only Not covered Not covered
Eyeglasses (frames & lenses) In-network: $0 copay In-network: $0 copay
Upgrades Not covered Not covered

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
Covered Service 2027 2026
Hearing exam In-network: $0 copay In-network: $0 copay
Fitting/evaluation In-network: $0 copay In-network: $0 copay
Prescription hearing aids In-network: $199-$475 copay In-network: $199-$1299 copay
OTC hearing aids In-network: $0 copay In-network: $0 copay

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
Covered Service 2027 2026
Adult day health services Not covered Not covered
Home-based palliative care Not covered Not covered
Personal emergency response system Coming soon Not covered
Weight management programs Not covered Not covered
Wigs for chemotherapy-related hair loss Coming soon Not covered
Alternative therapies Not covered Not covered
Massage therapy Not covered Not covered
Home/bathroom safety devices Not covered Not covered

Certain preventive services are covered 100% by Humana Gold Plus - Diabetes and Heart as a Part B benefit.

Prescription Drug Coverage

Humana Gold Plus - Diabetes and Heart 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 Gold Plus - Diabetes and Heart (H1036-302-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:($48.80)
Supplemental Part D Premium:$48.80
Total Part D Premium:$0.00
Low-Income Premium Subsidy:$7.28
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 $700.00 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 Gold Plus - Diabetes and Heart may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Humana Gold Plus - Diabetes and Heart (H1036-302-0) 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 Brand14% coinsurance$45.00 copay
Non-Preferred Drug50% coinsurance50% coinsurance
Specialty Tier25% coinsurance25% coinsurance
Select Care Drugs$0.00 copay$0.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H1036)

CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.

2027 Medicare Star Ratings for Contract H1036
CMS Measure Star Rating
2027 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 ☆☆☆☆☆
Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

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 Chronic Condition Special Needs Plans (C-SNPs) April 28, 2026
CMS.gov Medicare Advantage Plan Fact Sheet April 28, 2026
Medicare.gov Joining a plan April 28, 2026

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.