Humana Gold Plus H5619-116 (HMO)
Humana · HMO · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $2,100
- Drug deductible
- $615
- Tied for highest here
- Medicare star rating
- 3 of 5
In plain English
Compared with the 19 other plans in Kern County that the same person could join.
What stands out
- No monthly premium
- $0 for a 5-day hospital stay, tied for lowest here
- Dental: plan pays up to $2,000 a year, more than most plans here
- Dental, vision and hearing extras included
Watch out for
- $65 for urgent care, tied for highest here
- $615 drug deductible, tied for highest here
- You need a referral to see a specialist
- Covers only the plan’s own doctors and hospitals, except in an emergency or for urgent care
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$130$0 in premiums + $130 for careHigher than most plans here2 checkups and 2 lab tests.Uses the highest listed cost for: Lab tests.
- A busier year$390$0 in premiums + $390 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Uses the highest listed cost for: Lab tests, X-rays.
- A hard year$875$0 in premiums + $875 for care6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Uses the highest listed cost for: Lab tests.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$0Referral neededPlan approval may be needed
- Urgent care$65Tied for highest here
- Emergency room$150Not charged if you stay in the hospital within 24 hours
- Hospital stay$0 per stayTied for lowest hereReferral neededPlan approval may be needed
- Lab tests$0 to $65Depends on the serviceReferral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$0Referral neededPlan approval may be needed
- Outpatient hospital care$0 to $35Depends on the service
- X-rays$0 to $65Depends on the serviceReferral neededPlan approval may be needed
- MRI, CT and other scans$0Referral neededPlan approval may be needed
- Ground ambulance$335Tied for highest herePlan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $218 a day for days 21 to 100Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2026. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 19 other plans in Kern County that the same person could join. Read the plan’s 2026 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2Generic | $5 |
| 3Preferred Brand | $47 |
| 4Non-Preferred DrugAfter the deductible | 50% of the price |
| 5Specialty TierAfter the deductible | 25% of the price |
For a 1-month supply. The $615 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2026, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams: $0. Fillings, crowns and dentures covered.Cleanings and exams: plan pays up to $2,000 a year. Plan pays up to $2,000 a year for all dental.
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $300 a year.
- Hearing IncludedHearing test: $0. Hearing aids covered.
- Over-the-counter items IncludedCovered for things like vitamins, pain relief and bandages.
- Fitness IncludedIncludes gym or fitness classes.
- Rides to care Not included
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Humana Gold Plus H5619-116 (HMO), plan number H5619-116, for 2026?”