Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Humana Gold Plus: Diabetes and Heart, 2027

H4461Contract042Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 34 counties in Tennessee

Run by Cariten Health Plan Inc. (contract H4461), sold as Humana, owned by Humana Inc.

Renews for 2027

2026 star rating, contract H4461: 4 of 5

Humana Gold Plus: Diabetes and Heart (H4461-042) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,800 ($9,250 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
In-network out-of-pocket limit	$9,250	$9,800	up $550
Drug deductible	$615	$250	down $365
Specialist visit	$35 copay	$30 copay	down $5
Hospital stay, in network	$2,230 a stay	$2,100 a stay	down $130for a 5-day stay
Ground ambulance, in network	$335 copay	$325 copay	down $10
Eyewear, yearly limit	$450 a year	$200 a year	down $250
Counties served	7	34	up 27
Drug tier 2, generic	$5	$0	down $5
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	30% of the cost	up 5 points
11 lines do not change
Monthly premium	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Emergency room	$115 copay	$115 copay	no change
Medical deductible, in network	none	none	no change
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $218 a day for days 21–100	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
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?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	$5	$0
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	30% 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, 14 plans have a lower out-of-pocket limit, 4 a higher one. On the premium, 15 the same, 3 a higher one.

Out-of-pocket limits of the 19 chronic or disabling condition special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0004 plans

$6,000 to under $8,0009 plans

$8,000 to $10,000 (this plan)6 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 34 counties: $0 a month and $9,800.

Tennessee

Benton Chester Clay Crockett Decatur Dyer Fayette Fentress Gibson Hardeman Hardin Haywood Henderson Houston Jackson Lake Lauderdale Lawrence Lewis Macon Madison McNairy Moore Obion Overton Perry Pickett Shelby Smith Stewart Tipton Trousdale Van Buren Weakley

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: H4461-042
Legal name of the contract: Cariten Health Plan Inc.
Sold as: Humana
Parent company: Humana Inc.
Plan type: HMO C-SNP
2026 star rating of the contract: 4 of 5 overall; health plan 4 of 5, drug plan 3 of 5
Members, September 2026: 5,969
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 Shelby, TNWhere most of its members live; premiums and limits side by side
Every Humana plan for 2027Its contracts, counties and plans that end
The other 48 plans of contract H4461Same 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.