Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Humana Gold Plus: Diabetes and Heart, 2027
H1036Contract306Plan
HMO C-SNP · special needs plan, chronic or disabling condition · 14 counties in Oregon, Washington
Run by Humana Medical Plan, Inc. (contract H1036), sold as Humana, owned by Humana Inc.
Humana Gold Plus: Diabetes and Heart (H1036-306) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $4,550 ($5,500 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit | $5,500 | $4,550 | ▼down $950 |
| Drug deductible | $615 | $500 | ▼down $115 |
| Part B premium reduction, monthly | $1 | none | ▼dropped |
| Hospital stay, in network | $360 a day for days 1–4, then $0 a day for days 5–90 | $290 a day for days 1–4, then $0 a day for days 5–90 | ▼down $280for a 5-day stay |
| Skilled nursing facility, in network | $10 a day for days 1–20, then $218 a day for days 21–45, then $0 a day for days 46–100 | $10 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Ground ambulance, in network | $335 copay | $325 copay | ▼down $10 |
| Eyewear, yearly limit | $500 a year | $250 a year | ▼down $250 |
| Drug tier 2, generic | $10 | $7 | ▼down $3 |
| Drug tier 3, preferred brand | $47 | 17% of the cost | changed |
| Drug tier 4, non-preferred drug | 48% of the cost | 50% of the cost | ▲up 2 points |
| Drug tier 5, specialty tier | 25% of the cost | 28% of the cost | ▲up 3 points |
| 11 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $15 copay | $15 copay | no change |
| Emergency room | $115 copay | $115 copay | no change |
| Medical deductible, in network | none | none | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Over-the-counter items, yearly | not offered | not offered | no change |
| Counties served | 14 | 14 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 6, select care drugs | $0 | $0 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $10 | $7 |
| Tier 3 | Preferred Brand | $47 | 17% of the cost |
| Tier 4 | Non-Preferred Drug | 48% of the cost | 50% of the cost |
| Tier 5 | Specialty Tier | 25% of the cost | 28% of the cost |
| Tier 6 | Select Care Drugs | $0 | $0 |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 19 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 18 a higher one. On the premium, 17 the same, 1 a higher one.
Out-of-pocket limits of the 19 chronic or disabling condition special needs plans
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 14 counties: $0 a month and $4,550.
Oregon
Washington
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H1036-306
- Legal name of the contract
- Humana Medical Plan, Inc.
- Sold as
- Humana
- Parent company
- Humana Inc.
- Plan type
- HMO C-SNP
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4 of 5, drug plan 4 of 5
- Members, September 2026
- 9,313
- Plan website, as filed with CMS
- www.humana.com/medicare
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Clark, WAWhere most of its members live; premiums and limits side by side
- Every Humana plan for 2027Its contracts, counties and plans that end
- The other 84 plans of contract H1036Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.