Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Humana Gold Plus: Diabetes and Heart, 2027
H4461Contract085Plan
HMO C-SNP · special needs plan, chronic or disabling condition · 6 counties in Texas
Run by Cariten Health Plan Inc. (contract H4461), sold as Humana, owned by Humana Inc.
Humana Gold Plus: Diabetes and Heart (H4461-085) costs $0 a month in 2027, with an in-network out-of-pocket limit of $9,850. It is a new plan for 2027.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | not offered | $0 | new for 2027 |
| In-network out-of-pocket limit | not filed | $9,850 | new for 2027 |
| Drug deductible | not filed | $50 | new for 2027 |
| Primary care visit | not offered | $0 copay | changed |
| Specialist visit | not offered | 20% of the cost | changed |
| Emergency room | not offered | $115 copay | changed |
| Hospital stay, in network | not offered | $2,241 a stay | changed |
| Skilled nursing facility, in network | not offered | $0 a day for days 1–20, then $221 a day for days 21–100 | changed |
| Ground ambulance, in network | not offered | 20% of the cost | changed |
| Eyewear, yearly limit | not offered | $250 a year | ▲added |
| 6 lines do not change | |||
| Part B premium reduction, monthly | none | none | 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 | not offered | 6 | new for 2027 |
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 | not offered | $0 |
| Tier 2 | Generic | not offered | $0 |
| Tier 3 | Preferred Brand | not offered | 25% of the cost |
| Tier 4 | Non-Preferred Drug | not offered | 25% of the cost |
| Tier 5 | Specialty Tier | not offered | 32% of the cost |
| Tier 6 | Select Care Drugs | not offered | $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, 53 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 35 plans have a lower out-of-pocket limit, 17 the same. On the premium, 46 the same, 6 a higher one.
Out-of-pocket limits of the 53 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 6 counties: $0 a month and $9,850.
Texas
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
- H4461-085
- 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
- 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 Harris, TXWhere 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.