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

Humana Gold Plus: Diabetes and Heart, 2027

H5619Contract046Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 13 counties in Virginia

Run by Arcadian Health Plan, Inc. (contract H5619), sold as Humana, owned by Humana Inc.

Renews for 2027

2026 star rating, contract H5619: 3 of 5

Humana Gold Plus: Diabetes and Heart (H5619-046) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,850 ($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 get20262027Change
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$450$550up $100
Part B premium reduction, monthly$1nonedropped
Specialist visit$35 copay$50 copayup $15
Hospital stay, in network$375 a day for days 1–7, then $0 a day for days 8–90$385 a day for days 1–7, then $0 a day for days 8–90up $50for a 5-day stay
Ground ambulance, in network$335 copay$325 copaydown $10
Eyewear, yearly limit$150 a year$100 a yeardown $50
Drug tier 3, preferred brand$4717% of the costchanged
Drug tier 4, non-preferred drug47% of the cost50% of the costup 3 points
13 lines do not change
Monthly premium$0$0no change
Primary care visit$0 copay$0 copayno change
Emergency room$115 copay$115 copayno change
Medical deductible, in networknonenoneno 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 21–100no 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 served1313no change
Drug tier 1, preferred generic$0$0no change
Drug tier 2, generic$5$5no change
Drug tier 5, specialty tier27% of the cost27% 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$5$5
Tier 3Preferred Brand$4717% of the cost
Tier 4Non-Preferred Drug47% of the cost50% of the cost
Tier 5Specialty Tier27% of the cost27% 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, 12 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 7 plans have a lower out-of-pocket limit, 4 the same. On the premium, 9 the same, 2 a higher one.

Out-of-pocket limits of the 12 chronic or disabling condition special needs plans

$0 to under $2,0000 plans
$2,000 to under $4,0000 plans
$4,000 to under $6,0002 plans
$6,000 to under $8,0004 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 13 counties: $0 a month and $9,850.

Virginia

Chesapeake CityChesterfieldColonial Heights CityHampton CityHanoverHenricoHopewell CityNewport News CityNorfolk CityPetersburg CityPortsmouth CityRichmond CityVirginia Beach City

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
H5619-046
Legal name of the contract
Arcadian Health Plan, Inc.
Sold as
Humana
Parent company
Humana Inc.
Plan type
HMO C-SNP
2026 star rating of the contract
3 of 5 overall; health plan 3.5 of 5, drug plan 3 of 5
Members, September 2026
800
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.