Medicare Plans

Open Medicare Plan Data.

Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H5619-145 • 2027 • Bath County, VA

CMS Rating: Not yet rated by CMS.
Monthly Premium
$31.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Bath County, VA
Local Enrollment
0 beneficiaries in Bath County
Last update:

Introduction

Humana Gold Plus - Diabetes and Heart, offered by Humana, is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) identified by CMS Plan ID H5619-145. The plan's Health Maintenance Organization (HMO) provider network serves its covered medical benefits, and the plan includes Medicare Part D prescription drug coverage. Its 2027 costs include a $31.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.

This plan is available to eligible beneficiaries who live in Bath County, Virginia. According to CMS, 0 beneficiaries in Bath County are enrolled in this plan. New members can contact the plan at (888)873-0686 (TTY 711) for help and additional plan information.

Eligibility

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

Compare Similar Plans in Bath County

Compare this plan with the two most-enrolled HMO C-SNP plans available in Bath County, Virginia. Enrollment is based on CMS local enrollment data.

HMO C-SNP plan comparison for Bath County, Virginia
Plan Detail Humana Gold Plus - Diabetes and Heart Humana Gold Plus - Diabetes and Heart DEVOTED C-SNP PLUS 004 VA
CMS Plan ID H5619-145-0 H6622-084-0 H6994-004-0
Local Enrollment 0 0 0
Monthly Premium $31.00 $13.00 $0.00
Medical Deductible $0.00 $0.00 $990
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 $50 copay $50 copay 30% coinsurance
Part D Deductible $700.00 $550.00 $461.00
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 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 H5619-145.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5619-145-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $50 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0-$50 copay
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-$335 copay
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: $0-$130 copay
Diagnostic tests and procedures
In-network: $0-$120 copay, 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
$115 copay
Worldwide emergency care
Coming soon
Urgent care
$40 copay
Inpatient hospital care
Tier 1
$375 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Skilled Nursing Facility
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Ground ambulance
In-network: $325 copay

Mental Health Services

Outpatient individual therapy
In-network: $35 copay
Outpatient group therapy
In-network: $35 copay
Inpatient psychiatric hospital care
Tier 1
$375 per day for days 1-7
$0 per day for days 8-90
$0 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $25 copay
Occupational therapy
In-network: $25 copay

Medical Equipment and Supplies

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

Medicare Part B Drugs

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

Dental Services

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

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: $575-$750 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 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 (H5619-145-0) 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:$6.28
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 (H5619-145-0) 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$5.00 copay
Preferred Brand17% coinsurance$47.00 copay
Non-Preferred Drug50% coinsurance50% coinsurance
Specialty Tier25% coinsurance27% coinsurance
Select Care Drugs$0.00 copay$0.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H5619)

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 H5619
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 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 Chronic Condition Special Needs Plans (C-SNPs) April 28, 2026
Medicare.gov Understanding Medicare Advantage Plans April 28, 2026
Medicare.gov Joining a plan April 28, 2026

MedicarePlans.com operates as an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.

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