Medicare Advantage · C-SNP · HMO · 2027
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
No referral needed to see a specialist
At a glance: $0 monthly premium and $0 primary care visits.
Eligibility required for this C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. See who can enroll
- Monthly premium
- $0
- Part B premium separate
- Yearly limit
- $4,100
- Most you’d pay for in-network care
- Dental
- $2,500/yr
- Preventive & comprehensive dental allowance
- Doctor visits
- $0
- Primary care · specialists $25
Check this plan for you
Add your doctors and prescriptions to see how they work with this plan.
- DentalPreventive & comprehensive dental allowance
- $2,500/yr
- HearingCopay per hearing aid
- $499–$725
- VisionEyewear allowance
- $225/yr
- Fitness$0 fitness benefit
- Included
This is a supplemental benefit with plan-specific limits. See plan documents for details.
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Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.
Who can enroll
Eligibility for this Special Needs Plan
Eligibility required for this C-SNP
The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.
Costs and copays
Deductibles, yearly limit, visits, hospital stays and drug tiers
- DeductiblesMedical · $500 for drugs
- $0
- Yearly limitIn-network care, not counting drugs
- $4,100
- Primary doctorPer visit
- $0
- SpecialistPer visit · no referral needed
- $25
- Hospital stayNo limit on covered hospital days
- Days 1-7: $250/day, Days 8-90: $0/day, then $0/day
- Inpatient mental healthHospital stay
- Days 1-7: $250/day, Days 8-90: $0/day
- Outpatient surgeryPer procedure
- $300
- Emergency roomPer visit
- $150
- Urgent carePer visit
- $65
- Tier 1 · Preferred Generic30-day supply at a retail pharmacy
- $0
- Tier 2 · Generic30-day supply at a retail pharmacy
- $7
- Tier 3 · Preferred Brand30-day supply at a retail pharmacy, after deductible
- 17%
- Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy, after deductible
- 45%
- Tier 5 · Specialty30-day supply at a retail pharmacy, after deductible
- 28%
- Tier 6 · Drugs30-day supply at a retail pharmacy, after deductible
- $0
Our take
Where this plan shines, and what to know
Where this plan shines
- This plan has a $0 monthly premium.
- This plan’s out-of-pocket maximum is below the national median.
- See your primary doctor for $0.
- The specialist copay ($25) is among the more affordable options.
- No separate medical deductible.
- Highly rated by CMS (4 stars).
Things to know before you enroll
- You’ll need to use in-network providers except in emergencies.
- Limited coverage while traveling outside the plan’s service area.
Similar plans
Other Medicare Advantage plans offered in Oklahoma
Browse the full 2027 Chronic Condition Special Needs Plan directory. This plan is offered in Oklahoma. Plan availability can vary by county.
More Chronic Condition Special Needs Plan options
These plans are offered in at least one of the same states. Check your ZIP or county before choosing a plan.
- HumanaChoice - Diabetes and Heart (PPO C-SNP)Humana · H5216-372Offered in Oklahoma
- HumanaChoice - Diabetes and Heart (PPO C-SNP)Humana · H7617-078Offered in Oklahoma
- DEVOTED C-SNP CHOICE ENHANCED 009 OK (PPO C-SNP)Devoted Health · H2845-009Offered in Oklahoma
- DEVOTED C-SNP CHOICE ENHANCED 010 OK (PPO C-SNP)Devoted Health · H2845-010Offered in Oklahoma
- DEVOTED C-SNP CHOICE GIVEBACK EXTRAS 011 OK (PPO C-SNP)Devoted Health · H2845-011Offered in Oklahoma
- DEVOTED C-SNP CHOICE GIVEBACK EXTRAS 012 OK (PPO C-SNP)Devoted Health · H2845-012Offered in Oklahoma
Common questions
6 answers about this plan
What does Humana Gold Plus - Diabetes and Heart (HMO C-SNP) cover?
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is a Chronic Condition Special Needs Plan, a Medicare Advantage plan for people whose qualifying condition the plan verifies, including cardiovascular disorders and diabetes. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($2,500/yr preventive & comprehensive dental allowance), vision ($225/yr eyewear allowance), hearing ($499–$725 copay per hearing aid), and fitness ($0 fitness benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does Humana Gold Plus - Diabetes and Heart (HMO C-SNP) cost in 2027?
The published 2027 monthly plan premium for Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is $0. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $500. The in-network medical out-of-pocket maximum is $4,100; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $25. These figures are plan data, not a personal yearly-cost estimate.
Understand Medicare drug-cost limitsCan I use my current doctors with Humana Gold Plus - Diabetes and Heart (HMO C-SNP)?
CMS lists Humana Gold Plus - Diabetes and Heart (HMO C-SNP) as a HMO plan. The plan record says specialist referrals are not required. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.
Check your doctorsWhat chronic conditions qualify for Humana Gold Plus - Diabetes and Heart (HMO C-SNP)?
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is listed in the current plan record as a C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.
Learn about Special Needs PlansHow does Humana Gold Plus - Diabetes and Heart (HMO C-SNP) coordinate care for my chronic condition?
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is identified in the current plan record as a Chronic Condition Special Needs Plan for qualifying conditions that include Cardio DIS CHF and Diabetes. The record also lists dental ($2,500/yr preventive & comprehensive dental allowance), vision ($225/yr eyewear allowance), and hearing ($499–$725 copay per hearing aid). The data on this page does not describe a personal care plan or promise a specific care coordinator. Review the Evidence of Coverage and ask the plan how its model of care, provider communication, and medication support apply to your verified condition.
When can I enroll in Humana Gold Plus - Diabetes and Heart (HMO C-SNP)?
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a C-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsPlan documents
Summary of Benefits and Evidence of Coverage
- Summary of Benefits (PDF)Download the plan's official Summary of Benefits document
- Evidence of Coverage (PDF)Complete plan details and rules
- Check Your DoctorsSee if your doctors accept this plan
- Documentos en españolLlame a The Pocket Protector al 1-866-764-3312 (TTY: 711) para recibir ayuda con documentos en español
Enter your ZIP code to see how you can enroll
Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.
