Humana Gold Plus H0292-004 (HMO-POS)
4.5 stars — Above average. CMS rated contract H0292 4.5 out of 5 for 2027; every plan under H0292 carries the same rating. The rating measures the contract's past quality, member experience and service as CMS scored it (largely 2025 performance); it is not a recommendation. How CMS star ratings work
Summary of Benefits (PDF) ↗ Opens the plan's own 2027 Summary of Benefits on assets.humana.com. The carrier publishes and may update this document; it governs over the CMS-file summary on this page. Read it here.
Evidence of Coverage — find on Humana Inc. ↗
What this plan charges, as CMS shows it
| Primary care visit (in network) | $0 copay |
| Specialist visit (in network) | $35 copay per visit |
| Urgent care | $65 copay per visit (always covered) |
| Emergency room | $150 copay per visit (always covered) |
These four figures are reproduced exactly as CMS shows them on Medicare Plan Finder, including ranges (“$0-45 copay per visit”) and coinsurance, because Plan Finder is what a member is quoted on medicare.gov. Where the amount the plan filed in its Plan Benefit Package differs from Plan Finder, Plan Finder governs this table. The plan’s own Summary of Benefits is linked above and governs over both. Where CMS published no Plan Finder value for a service, the figure shown is the in-network maximum the plan filed — never the filed minimum, which is the bottom of a range and not a price. “—” means neither source published a value.
Supplemental benefits
| Benefit | Reported in bid | Allowance / plan maximum |
|---|---|---|
| Preventive dental | Yes | $4,000 |
| Comprehensive dental | Yes | Reported |
| Vision exam | Yes | Reported |
| Eyewear | Yes | $100 |
| Hearing exam | Yes | Reported |
| Hearing aids | Yes | Reported |
| Transportation | Yes | Reported |
| OTC allowance | Yes | Reported |
| Meals | Yes | Reported |
| Acupuncture | Yes | Reported |
| Chiropractic | No | — |
| Telehealth | Yes | Reported |
| Food / produce | — | — |
| Utilities support | — | — |
"Yes" means the plan's approved bid reports the benefit; it does not describe limits, frequency, networks, or eligibility. An allowance is the plan maximum CMS published for that benefit, per the period the plan defines. "Reported" means the benefit is offered but no amount was published.
Professional view: governed benefit records (14)
| Benefit | Code | Offered |
|---|---|---|
| Acupuncture | ACUPUNCTURE | Yes |
| Chiropractic | CHIROPRACTIC | No |
| Comprehensive dental | COMPREHENSIVE_DENTAL | Yes |
| Eyewear | EYEWEAR | Yes |
| Food and produce | FOOD_PRODUCE | — |
| Hearing aid | HEARING_AID | Yes |
| Hearing exam | HEARING_EXAM | Yes |
| Meals | MEALS | Yes |
| Over-the-counter | OTC | Yes |
| Preventive dental | PREVENTIVE_DENTAL | Yes |
| Telehealth | TELEHEALTH | Yes |
| Transportation | TRANSPORTATION | Yes |
| Utilities support | UTILITIES | — |
| Vision exam | VISION_EXAM | Yes |
Prior-year plan lineage (CMS crosswalk)
H0292-NEW: New Plan
Part D drug coverage
Formulary 00027366 · Part D deductible $350 · 5 tiers, per the CMS monthly formulary file.
Check a drug on this plan
Tier cost sharing
| Tier | Deductible applies | 30-day preferred retail | 30-day standard retail | 90-day preferred mail |
|---|---|---|---|---|
| 1 | No | — | $0 | $0 |
| 2 | No | — | $0 | $0 |
| 3 | Yes | — | 17% | 15% |
| 4 | Yes | — | 50% | 50% |
| 5 specialty | Yes | — | 29% | — |
Initial-coverage cost sharing as filed with CMS. A copay is shown in dollars, coinsurance as a percentage; "—" means that pharmacy type is not offered for the tier. Insulin is capped at $35 per month's supply by law; selected drugs under Medicare price negotiation have negotiated prices.
Pharmacies near you in this plan's network
Source: pharmacy network file in the CMS monthly Part D formulary release of 10/08/2026; pharmacy names, addresses and phone numbers from the CMS NPPES NPI registry. Distances are between ZIP code centers (Census 2020), so they are approximate. Networks change during the year: call the pharmacy or the plan to confirm before you fill a prescription.
Service area (6 counties)
Need help with this plan?
Member services: 1-800-457-4708 (TTY 711)
Grievances & appeals: Use the Customer Care number on your ID card; expedited appeals 1-800-867-6601
Other published numbers: Pharmacy prior authorization 1-800-555-2546; Part D (PDP) 1-800-281-6918
Plan website: www.humana.com/medicare ↗
Medicare: 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) · Free counseling (SHIP): 1-877-839-2675
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What the star rating means. CMS rates every Medicare Advantage contract (the "H" number in the plan ID — all plans under it share the rating) on a 1-to-5 scale each October, from about 40 measures of care quality, member experience, complaints and appeals, customer service and, for plans with drug coverage, drug safety and pricing. The 2027 rating is largely based on performance measured in 2025.
5 Excellent4 Above average3 Average2 Below average1 Poor
Not rated means CMS published no overall rating — usually a contract too new to be measured or with too few members ("not enough data"); it is not a low score. A 5-star contract can be joined outside the normal enrollment windows (the 5-star Special Enrollment Period, Dec 8 – Nov 30). Medicare.gov flags contracts rated below 3 stars for three years running as low-performing. Stars describe the contract's past performance as CMS measured it; they are not a recommendation, and they do not tell you whether a plan's network, drugs or costs fit you.
Source and definitions
Fields come from the CMS Plan Benefit Package (PBP) and landscape public use files for contract year 2027 (see the source ledger). Premium is the CMS consolidated monthly premium. MOOP is the in-network maximum out-of-pocket. Star rating is the contract's overall rating from the CMS file used in this build; "Not rated" means CMS published none for this contract. This page reports filings and does not recommend or sell any plan; the plan's Summary of Benefits and Evidence of Coverage govern.