Humana Gold Plus (HMO) (Humana) — Florida Medicare Advantage Plan
Humana Gold Plus (HMO) is an HMO Medicare Advantage plan from Humana with a $0 monthly premium, a CMS rating of 4.5 out of 5 stars, and a $4,900 annual out-of-pocket maximum. Prescription drug coverage is included. Included benefits: dental, vision, hearing, over-the-counter allowance, transportation, fitness membership.
- 4.5+ Star Rated
- $0 Premium
- Includes Dental
- Includes Drug Coverage
Takes about a minute · A licensed agent completes the application with you
At a glance
| Detail | Value |
|---|---|
| Monthly plan premium | $0 per month |
| Annual medical deductible | $0 |
| Annual out-of-pocket maximum | $4,900 |
| CMS star rating | 4.5 out of 5 stars |
| Plan type | HMO |
| Contract / plan ID | H1036-236 |
What this plan covers
Medical (Part B)
Covers everything Original Medicare Part B covers — doctor visits, outpatient care, preventive screenings, durable medical equipment, and mental health services — through a coordinated HMO network.
Hospital (Part A)
Covers everything Part A covers, including inpatient hospital stays, skilled nursing facility care after a qualifying stay, hospice through Original Medicare, and home health services.
Prescription drugs (Part D)
Part D prescription coverage is built in with no separate drug premium and no drug deductible on Tier 1 and Tier 2 medications. Mail-order supplies are available at a reduced cost share.
Extra benefits
- Dental
- Vision
- Hearing
- Fitness membership
- Over-the-counter allowance: $60 per quarter for over-the-counter items
- Transportation: 24 one-way trips per year to approved medical appointments
Costs and copays
| Service | You pay in network |
|---|---|
| Primary care visit | $0 |
| Specialist visit | $35 |
| Urgent care | $40 |
| Emergency room | $120 (waived if admitted) |
| Inpatient hospital (per stay) | $350 per day, days 1–5 |
| Lab work | $0 |
| Diagnostic imaging (MRI, CT) | $125 |
| Generic drugs (Tier 1) | $0 |
| Preferred brand drugs (Tier 3) | $47 |
Typical in-network cost sharing. Amounts shown are standard cost shares for this plan and can change each plan year — always confirm against the plan's Summary of Benefits before enrolling.
Who this plan may fit
- People who already see doctors inside the Humana network and want to keep them
- Anyone who wants dental, vision, hearing, and drug coverage bundled into a single $0-premium plan
- Households on a fixed income who need a lower out-of-pocket maximum than most $0-premium plans offer
- People who do not travel much outside Florida during the year
Who it may not suit
It may not suit you if your doctors are outside the network, if you spend several months a year in another state, or if you want the freedom to see specialists without a referral.
How to use this plan
- Finding in-network providers
- Search the carrier's online provider directory by name, specialty, and ZIP code, or call us and we will check your doctors against the network before you enroll.
- Do you need referrals?
- Yes — this is an HMO, so you choose a primary care physician who coordinates your care and issues referrals to specialists.
- How prior authorization works
- Certain services — planned inpatient stays, advanced imaging, some outpatient surgeries, durable medical equipment, and specialty drugs — need approval before the plan pays. Your provider submits the request; ask them to confirm approval before scheduling.
- Traveling and coverage away from home
- Urgent and emergency care is covered anywhere in the United States. Routine care outside the service area is generally not covered, so schedule check-ups for when you are home.
Where this plan is available (34 counties)
Select your county to see everything available where you live. Eligibility is based on your permanent address.
- Alachua County
- Bay County
- Brevard County
- Broward County
- Charlotte County
- Citrus County
- Clay County
- Collier County
- Duval County
- Escambia County
- Hernando County
- Hillsborough County
- Indian River County
- Lake County
- Lee County
- Leon County
- Manatee County
- Marion County
- Martin County
- Miami-Dade County
- Okaloosa County
- Orange County
- Osceola County
- Palm Beach County
- Pasco County
- Pinellas County
- Polk County
- Santa Rosa County
- Sarasota County
- Seminole County
- St. Johns County
- St. Lucie County
- Sumter County
- Volusia County
How to enroll in this plan
You can join this plan when you first become eligible for Medicare, during your seven-month Initial Enrollment Period around your 65th birthday.
After that, the Annual Enrollment Period runs October 15 to December 7 each year, with coverage starting January 1. If you are already in a Medicare Advantage plan, Medicare Advantage Open Enrollment from January 1 to March 31 lets you make one switch.
Outside those windows, a qualifying life event such as a move, a loss of employer coverage, or a change in Medicaid eligibility can open a Special Enrollment Period that lets you enroll right away.
Takes about a minute · A licensed agent completes the application with you
Answer These Quick Questions to Enroll Into Humana Today
Check whether this plan covers your doctors and prescriptions
A licensed agent will run your providers and medication list against this plan before you enroll, and show you the comparable plans in your county so you can see the trade-offs.
Monday – Friday, 8:00 am – 8:00 pm ET · Saturday, 9:00 am – 5:00 pm ET
Questions about this plan
How much does Humana Gold Plus (HMO) cost each month?
The plan premium is $0 per month. You also continue to pay your Medicare Part B premium, which goes to Medicare rather than to Humana. Beyond premiums you pay copays as you use services, up to an annual out-of-pocket maximum of $4,900.
Does Humana Gold Plus (HMO) include prescription drug coverage?
Yes. Part D coverage is built into this plan, so you do not need — and should not buy — a separate prescription drug plan. Tier 1 generics start at $0.
Do I need a referral to see a specialist on Humana Gold Plus (HMO)?
Yes — this is an HMO, so you choose a primary care physician who coordinates your care and issues referrals to specialists.
What is the CMS star rating for Humana Gold Plus (HMO)?
Medicare rates this plan 4.5 out of 5 stars. Star ratings measure things like preventive care, member experience, customer service, and how quickly problems get resolved. Ratings are published each fall and can change from year to year.
Which Florida counties can I enroll in Humana Gold Plus (HMO)?
CMS approved this plan in 34 Florida counties. Medicare Advantage plans are approved county by county, so your eligibility depends on the address where you actually live.
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