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Humana Gold Plus Giveback H5619-150 (HMO)

H5619 - 150 - 0
3.5 out of 5 stars (3.5 / 5)

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Humana Gold Plus Giveback H5619-150 (HMO) is a Medicare Advantage Plan by Humana.

This page features plan details for 2025 Humana Gold Plus Giveback H5619-150 (HMO) H5619 – 150 – 0 available in Central/Southern California Area.

Locations

Humana Gold Plus Giveback H5619-150 (HMO) is offered in the following locations.

California
Fresno County, California
Kern County, California

Click to see more locations

Plan Overview

Humana Gold Plus Giveback H5619-150 (HMO) offers the following coverage and cost-sharing.

Insurer:Humana
Health Plan Deductible:$0
MOOP:$5,000 In-network
Drugs Covered:Yes

Ready to sign up for Humana Gold Plus Giveback H5619-150 (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Humana Gold Plus Giveback H5619-150 (HMO) qualifies for a monthly Medicare Give Back Benefit of $57.00.

Premium Reduction:$57.00

Premium Breakdown

Humana Gold Plus Giveback H5619-150 (HMO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $0.00 $57.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Humana Gold Plus Giveback H5619-150 (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $0.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

Humana Gold Plus Giveback H5619-150 (HMO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Prosthodontics, fixed
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Prosthodontics, removable
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required, Referral Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay

Diagnostic procedures/lab services/imaging

  • Lab services
    • $0-55 copay (Authorization Required, Referral Required)
  • Outpatient x-rays
    • $0-100 copay (Authorization Required, Referral Required)
  • Diagnostic radiology services (e.g., MRI)
    • $0-200 copay (Authorization Required, Referral Required)
  • Diagnostic tests and procedures
    • $0-100 copay (Authorization Required, Referral Required)

Doctor visits

  • Primary
    • $0 copay
  • Specialist
    • $30 copay per visit (Authorization Required, Referral Required)

Emergency care/Urgent care

  • Emergency
    • $120 copay per visit (always covered)
  • Urgent care
    • $55 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • $30 copay (Authorization Required, Referral Required)
  • Routine foot care
    • Not covered

Ground ambulance

    • $300 copay

Health plan deductible

    • $0

Hearing

  • Hearing aids OTC
    • Not covered
  • Fitting/evaluation
    • $0 copay (Authorization Required, Referral Required)
  • Hearing aids
    • $499-799 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • $30 copay (Authorization Required, Referral Required)

Inpatient hospital coverage

    • $250 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required, Referral Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $5,000 In-network

Medical equipment/supplies

  • Diabetes supplies
    • $0 copay or 10% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • 20% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient group therapy visit
    • $30 copay (Authorization Required, Referral Required)
  • Outpatient group therapy visit with a psychiatrist
    • $30 copay (Authorization Required, Referral Required)
  • Inpatient hospital – psychiatric
    • $250 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required, Referral Required)
  • Outpatient individual therapy visit
    • $30 copay (Authorization Required, Referral Required)
  • Outpatient individual therapy visit with a psychiatrist
    • $30 copay (Authorization Required, Referral Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • $0-250 copay per visit (Authorization Required, Referral Required)

Preventive care

    • $0 copay

Rehabilitation services

  • Physical therapy and speech and language therapy visit
    • $15 copay (Authorization Required, Referral Required)
  • Occupational therapy visit
    • $15 copay (Authorization Required, Referral Required)

Skilled Nursing Facility

    • $10 per day for days 1 through 20
      $203 per day for days 21 through 100 (Authorization Required, Referral Required)

Transportation

    • Not covered

Vision

  • Eyeglass lenses
    • Not covered
  • Contact lenses
    • $0 copay (Limits Apply, Authorization Required, Referral Required)
  • Upgrades
    • Not covered
  • Eyeglass frames
    • Not covered
  • Eyeglasses (frames and lenses)
    • $0 copay (Limits Apply, Authorization Required, Referral Required)
  • Other
    • Not covered
  • Routine eye exam
    • $0 copay (Limits Apply, Authorization Required, Referral Required)

Wellness programs (e.g., fitness, nursing hotline)

    • Not covered

Ready to sign up for Humana Gold Plus Giveback H5619-150 (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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