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

Humana Gold Plus: Diabetes and Heart, 2027

H4461Contract068Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 22 counties in Texas

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 (H4461-068) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $3,900.

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 get20262027Change
Drug deductible$615$500down $115
Part B premium reduction, monthly$1nonedropped
Skilled nursing facility, in network$20 a day for days 1–20, then $218 a day for days 21–100$20 a day for days 1–20, then $221 a day for days 21–100up $30for a 30-day stay
Ground ambulance, in network$335 copay$325 copaydown $10
Eyewear, yearly limit$250 a year$200 a yeardown $50
Drug tier 3, preferred brand$4717% of the costchanged
Drug tier 5, specialty tier25% of the cost28% of the costup 3 points
15 lines do not change
Monthly premium$0$0no change
In-network out-of-pocket limit$3,900$3,900no change
Primary care visit$0 copay$0 copayno change
Specialist visit$15 copay$15 copayno change
Emergency room$150 copay$150 copayno change
Medical deductible, in networknonenoneno change
Hospital stay, in network$260 a day for days 1–5, then $0 a day for days 6–90$260 a day for days 1–5, then $0 a day for days 6–90no change
Comprehensive dental, yearly limitnot offerednot offeredno change
Hearing aids, yearly limit for both earsnot offerednot offeredno change
Over-the-counter items, yearlynot offerednot offeredno change
Counties served2222no change
Drug tier 1, preferred generic$0$0no change
Drug tier 2, generic$0$0no change
Drug tier 4, non-preferred drug50% of the cost50% of the costno change
Drug tier 6, select care drugs$0$0no 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
TierWhat the tier holds20262027
Tier 1Preferred Generic$0$0
Tier 2Generic$0$0
Tier 3Preferred Brand$4717% of the cost
Tier 4Non-Preferred Drug50% of the cost50% of the cost
Tier 5Specialty Tier25% of the cost28% of the cost
Tier 6Select 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, 14 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 3 plans have a lower out-of-pocket limit, 1 the same, 9 a higher one. On the premium, 12 the same, 1 a higher one.

Out-of-pocket limits of the 14 chronic or disabling condition special needs plans

$0 to under $2,0000 plans
$2,000 to under $4,000 (this plan)5 plans
$4,000 to under $6,0001 plan
$6,000 to under $8,0004 plans
$8,000 to $10,0004 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 22 counties: $0 a month and $3,900.

Texas

AndersonAngelinaBowieCassDeltaFanninFreestoneGreggHarrisonHaysHendersonLamarLeonNacogdochesRed RiverRuskSmithTitusTravisUpshurVan ZandtWilliamson

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
H4461-068
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
5,097
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?

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.