Humana Gold Plus H5619-061 (HMO)

ARCADIAN HEALTH PLAN, INC. · 2026 plan year

Plan ID H5619-061-000

HMO★ 3 CMS Stars
MOOP (in-network)
$4,200
MOOP (combined)
—
Monthly premium
$63/mo
Part C $28.40 + Part D $34.60, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H5619-061-000
Medical deductible
$0 — no deductible
Part D premium
$34.60/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$615/yr
Also owed
Your Medicare Part B premium, paid separately

More ARCADIAN HEALTH PLAN, INC. plans in WA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$340/day for days 1–7, $0 after
Inpatient Hospital — Psychiatric$340/day for days 1–7, $0 after
Worldwide Urgent Care Coverage$150
Inpatient Hospital — Additional Days (Acute)No charge

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$20/day for days 1–20, $218/day for days 21–40, $0 after
Cardiac Rehabilitation — Additional Sessions$10
Intensive Cardiac Rehabilitation — Additional Sessions$10
Pulmonary Rehabilitation — Additional Sessions$5
Emergency Services$150
Urgently Needed Services$55
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Worldwide Emergency Transportation$150
Partial Hospitalization Program$35
Intensive Outpatient Program (IOP)$35
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$20
Occupational Therapy Services$20
Physician Specialist Services$40
Podiatry Services$40
Other Health Care Professional Services$0-$40
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language Pathology$20
Additional Telehealth Services (Part B)$0-$55
Opioid Treatment Program Services$0-$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$55
Laboratory Services$0-$55
Radiological ServicesSee plan details
Diagnostic Radiology$0-$335
Therapeutic Radiology20% coinsurance
X-Ray Services$0-$130
Outpatient Hospital Services$0-$340
Hospital Observation Services$340 per stay
Ambulatory Surgical Center (ASC)$0-$100
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$0-$35
Substance Abuse — Group Sessions$0-$35
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$335
Air Ambulance$1,250
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & Inserts$10
Dialysis Services20% coinsurance
Acupuncture$40
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$40
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Other Preventive ServicesNo charge
Dental — Restorative Services$25
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$40
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Hearing — Exams$40
Hearing — ExamsSee plan details
Cardiac & Pulmonary RehabilitationSee plan details
Supervised Exercise Therapy (SET)$5
Prosthetic Devices20% coinsurance
Diabetes Self-Management TrainingNo charge
Dental — ComprehensiveSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$699-$999
Diabetic Supplies10%-20% coinsurance

Service area

  • WA: 31 counties

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