HMO/HMOPOS · observed 2026 → 2026 · 75 months of CPSC history · 86 active CY 2026 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| Humana Gold Plus H1036-335 (HMO-POS) H1036/335 | MA-PD | $0 | $3,911 | 4.5 | 81 | 111,857 |
| Humana Gold Plus Giveback H1036-265 (HMO) H1036/265 | MA-PD | $0 | $2,600 | 4.5 | 9 | 56,304 |
| Humana Gold Plus SNP-DE H1036-314 (HMO D-SNP) H1036/314 · Dual-Eligible | SNP | $0 | $3,400 | 4.5 | 36 | 54,256 |
| Humana Gold Plus H1036-065C (HMO) H1036/065 | MA-PD | $0 | $1,000 | 4.5 | 1 | 48,979 |
| Humana Gold Plus SNP-DE H1036-304 (HMO D-SNP) H1036/304 · Dual-Eligible | SNP | $0 | $3,400 | 4.5 | 3 | 38,119 |
| Humana Gold Plus H1036-054C (HMO) H1036/054 | MA-PD | $0 | $500 | 4.5 | 1 | 33,324 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H1036/299 · Chronic or Disabling Condition | SNP | $0 | $2,000 | 4.5 | 10 | 27,322 |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) H1036/331 · Dual-Eligible | SNP | $20 | $9,250 | 4.5 | 96 | 24,496 |
| Humana Gold Plus H1036-062C (HMO) H1036/062 | MA-PD | $0 | $1,625 | 4.5 | 1 | 23,867 |
| Humana Gold Plus Giveback H1036-269 (HMO) H1036/269 | MA-PD | $0 | $3,200 | 4.5 | 6 | 21,043 |
| Humana Gold Plus H1036-333 (HMO) H1036/333 | MA-PD | $0 | $4,900 | 4.5 | 27 | 19,765 |
| Humana Gold Plus H1036-151 (HMO) H1036/151 | MA-PD | $0 | $4,900 | 4.5 | 10 | 19,426 |
| Humana Gold Plus Giveback H1036-305 (HMO) H1036/305 | MA-PD | $0 | $3,850 | 4.5 | 3 | 18,875 |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) H1036/318 | MA-PD | $0 | $9,250 | 4.5 | 40 | 16,894 |
| Humana Gold Plus H1036-025 (HMO) H1036/025 | MA-PD | $0 | $2,000 | 4.5 | 4 | 15,752 |
| Humana Dual Integrated (HMO D-SNP) H1036/339 · Dual-Eligible | SNP | $0 | $9,250 | 4.5 | 8 | 15,333 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H1036/121 · Chronic or Disabling Condition | SNP | $0 | $2,450 | 4.5 | 3 | 14,265 |
| Humana Gold Plus Giveback H1036-157 (HMO) H1036/157 | MA-PD | $0 | $3,700 | 4.5 | 2 | 13,347 |
| Humana Gold Plus H1036-146 (HMO) H1036/146 | MA-PD | $0 | $2,400 | 4.5 | 6 | 11,641 |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) H1036/167 · Dual-Eligible | SNP | $14 | $9,250 | 4.5 | 96 | 11,253 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H1036/308 · Chronic or Disabling Condition | SNP | $0 | $9,250 | 4.5 | 96 | 10,076 |
| Humana Gold Plus H1036-321 (HMO) H1036/321 | MA-PD | $0 | $5,900 | 4.5 | 4 | 10,076 |
| Humana Dual Integrated (HMO D-SNP) H1036/340 · Dual-Eligible | SNP | $0 | $9,250 | 4.5 | 31 | 10,011 |
| Humana Gold Plus H1036-137 (HMO-POS) H1036/137 | MA-PD | $0 | $9,250 | 4.5 | 15 | 9,994 |
| Humana Gold Plus H1036-044 (HMO) H1036/044 | MA-PD | $0 | $2,700 | 4.5 | 2 | 9,541 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 4.0 |
| C02 | Colorectal Cancer Screening | 5.0 |
| C03 | Annual Flu Vaccine | 2.0 |
| C04 | Improving or Maintaining Physical Health | 3.0 |
| C05 | Improving or Maintaining Mental Health | 1.0 |
| C06 | Monitoring Physical Activity | 3.0 |
| C07 | Special Needs Plan (SNP) Care Management | 4.0 |
| C08 | Care for Older Adults – Medication Review | 4.0 |
| C09 | Care for Older Adults – Pain Assessment | 5.0 |
| C10 | Osteoporosis Management in Women who had a Fracture | 4.0 |
| C11 | Diabetes Care – Eye Exam | 5.0 |
| C12 | Diabetes Care – Blood Sugar Controlled | 4.0 |
| C13 | Kidney Health Evaluation for Patients with Diabetes | 5.0 |
| C14 | Controlling High Blood Pressure | 4.0 |
| C15 | Reducing the Risk of Falling | 3.0 |
| C16 | Improving Bladder Control | 3.0 |
| C17 | Medication Reconciliation Post-Discharge | 5.0 |
| C18 | Plan All-Cause Readmissions | 3.0 |
| C19 | Statin Therapy for Patients with Cardiovascular Disease | 4.0 |
| C20 | Transitions of Care | 4.0 |
| C21 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 4.0 |
| C22 | Getting Needed Care | 4.0 |
| C23 | Getting Appointments and Care Quickly | 4.0 |
| C24 | Customer Service | 4.0 |
| C25 | Rating of Health Care Quality | 4.0 |
| C26 | Rating of Health Plan | 5.0 |
| C27 | Care Coordination | 3.0 |
| C28 | Complaints about the Health Plan | 4.0 |
| C29 | Members Choosing to Leave the Plan | 4.0 |
| C30 | Health Plan Quality Improvement | 4.0 |
| C31 | Plan Makes Timely Decisions about Appeals | 4.0 |
| C32 | Reviewing Appeals Decisions | 4.0 |
| C33 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D01 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D02 | Complaints about the Drug Plan | 4.0 |
| D03 | Members Choosing to Leave the Plan | 4.0 |
| D04 | Drug Plan Quality Improvement | 3.0 |
| D05 | Rating of Drug Plan | 5.0 |
| D06 | Getting Needed Prescription Drugs | 4.0 |
| D07 | MPF Price Accuracy | 1.0 |
| D08 | Medication Adherence for Diabetes Medications | 4.0 |
| D09 | Medication Adherence for Hypertension (RAS antagonists) | 4.0 |
| D10 | Medication Adherence for Cholesterol (Statins) | 4.0 |
| D11 | MTM Program Completion Rate for CMR | 3.0 |
| D12 | Statin Use in Persons with Diabetes (SUPD) | 4.0 |