Gonzaba News for Agents

Hello, San Antonio! I am Jose Perez, your local Humana Broker Relationship Manager, alongside Michael Renteria, and we are committed to helping you navigate Humana’s 2026 benefits and agent support tools with greater ease and confidence, while keeping the needs of our members at the center of everything we do. For 2026, Humana continues to deliver meaningful growth through enhanced benefits and expanded market presence, while maintaining a strong focus on affordability.

2026 HMO Highlights include:

Humana Gold Plus (HMO) – H4461-058-000

• Monthly premium: $0.00
• MOOP: $3400 in-network
• PCP: $0 copayment
• Specialist: $15 copayment
• Acute inpatient: $95 per day (days 1–5)
• Emergency/Urgent care: $65 copayment / $150 copayment
• Rx deductible: $615 (Tiers 4, 5)
• Rx copays: $0/$0/$45/46%/25%
• Dental: $4000 annually
• Vision: $300 annually for eyewear (PLUS Provider)
• Hearing: $299 copayment for Advanced; $0 for Standard
• OTC: OTC Debit Card $75/Quarter with rollover

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Humana Gold Plus – Diabetes and Heart (HMO C-SNP) – H4461-066-000

• Monthly premium: $0.00
• MOOP: $3450 in-network
• PCP: $0 copayment
• Specialist: $10 copayment
• Acute inpatient: $95 per day (days 1–5)
• Emergency/Urgent care: $65 copayment / $150 copayment
• Advanced imaging: $200 copayment; $300 copayment
• Rx deductible: $615 (Tiers 4, 5)
• Rx copays: $0/$0/$45/47%/25%
• Dental: $2000 annually
• Vision: $250 annually for eyewear (PLUS Provider)
• Hearing: $0 copayment for Advanced; $0 for Standard
• Healthy Options allowance: $75/Quarter with rollover

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Humana Gold Plus SNP-DE (HMO D-SNP) – H4461-069-000

• Monthly premium: $0.00
• MOOP: $0
• PCP: $0 copayment
• Specialist: $0 copayment
• Acute inpatient: $0
• Emergency/Urgent care: $0
• Advanced imaging: $0
• Rx deductible: $0
• Rx copays: $0/$0/LIS Copays T3–T5
• Dental: $3000 annually
• Vision: $300 annually for eyewear (PLUS Provider)
• Hearing: $0 copayment for Advanced; $0 for Standard
• Healthy Options allowance: $75 monthly with rollover

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Humana Gold Plus SNP-DE (HMO D-SNP) – H4461-070-000

• Monthly premium: $0.00
• MOOP: $0
• PCP: $0 copayment
• Specialist: $0 copayment
• Acute inpatient: $0
• Emergency/Urgent care: $0
• Advanced imaging: $0
• Rx deductible: $0
• Rx copays: $0/$0/LIS Copays T3–T5
• Dental: $3000 annually
• Vision: $300 annually for eyewear (PLUS Provider)
• Hearing: $0 copayment for Advanced; $0 for Standard
• Healthy Options allowance: $215 monthly with rollover