HMO/HMOPOS · observed 2026 → 2026 · 75 months of CPSC history · 46 active CY 2026 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| Humana Gold Plus H4461-041 (HMO) H4461/041 | MA-PD | $10 | $3,200 | 4.0 | 35 | 40,843 |
| Humana Gold Plus H4461-035 (HMO) H4461/035 | MA-PD | $0 | $3,600 | 4.0 | 35 | 33,718 |
| Humana Gold Plus H4461-040 (HMO) H4461/040 | MA-PD | $74 | $1,900 | 4.0 | 36 | 32,707 |
| Humana Gold Plus H4461-025 (HMO) H4461/025 | MA-PD | $0 | $4,700 | 4.0 | 33 | 21,548 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H4461/066 · Chronic or Disabling Condition | SNP | $0 | $3,450 | 4.0 | 19 | 14,258 |
| Humana Total Complete Giveback H4461-047 (HMO-POS) H4461/047 | MA-PD | $0 | $4,200 | 4.0 | 13 | 14,048 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H4461/067 · Chronic or Disabling Condition | SNP | $0 | $3,500 | 4.0 | 12 | 11,517 |
| Humana Total Complete H4461-051 (HMO) H4461/051 | MA-PD | $0 | $3,200 | 4.0 | 14 | 11,390 |
| Humana USAA Honor Giveback (HMO) H4461/004 | MA | — | $3,750 | 4.0 | 88 | 11,266 |
| Humana Total Complete H4461-046 (HMO) H4461/046 | MA-PD | $0 | $2,700 | 4.0 | 17 | 10,752 |
| Humana Total Complete H4461-043 (HMO) H4461/043 | MA-PD | $0 | $7,018 | 4.0 | 19 | 9,630 |
| Humana Gold Plus SNP-DE H4461-071 (HMO D-SNP) H4461/071 · Dual-Eligible | SNP | $0 | $9,250 | 4.0 | 48 | 7,421 |
| Humana Gold Plus SNP-DE H4461-069 (HMO D-SNP) H4461/069 · Dual-Eligible | SNP | $2 | $9,250 | 4.0 | 19 | 6,865 |
| Humana Total Complete H4461-049 (HMO) H4461/049 | MA-PD | $0 | $3,400 | 4.0 | 3 | 6,417 |
| Humana Gold Plus H4461-058 (HMO) H4461/058 | MA-PD | $0 | $3,400 | 4.0 | 8 | 6,187 |
| Humana Gold Plus SNP-DE H4461-044 (HMO-POS D-SNP) H4461/044 · Dual-Eligible | SNP | $17 | $9,250 | 4.0 | 37 | 5,847 |
| Humana Gold Plus SNP-DE H4461-070 (HMO D-SNP) H4461/070 · Dual-Eligible | SNP | $0 | $9,250 | 4.0 | 19 | 5,389 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H4461/042 · Chronic or Disabling Condition | SNP | $0 | $9,250 | 4.0 | 7 | 5,388 |
| Humana Essentials Plus Giveback H4461-039 (HMO) H4461/039 | MA-PD | $0 | $9,250 | 4.0 | 19 | 4,700 |
| Humana Gold Plus SNP-DE H4461-072 (HMO D-SNP) H4461/072 · Dual-Eligible | SNP | $0 | $9,250 | 4.0 | 16 | 4,433 |
| Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP) H4461/038 · Dual-Eligible | SNP | $15 | $9,250 | 4.0 | 88 | 4,078 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H4461/068 · Chronic or Disabling Condition | SNP | $0 | $3,900 | 4.0 | 22 | 3,984 |
| Humana Essentials Plus Giveback H4461-045 (HMO) H4461/045 | MA-PD | $0 | $4,200 | 4.0 | 17 | 3,567 |
| Humana Gold Plus H4461-054 (HMO) H4461/054 | MA-PD | $0 | $4,850 | 4.0 | 7 | 3,213 |
| Humana Total Complete H4461-064 (HMO) H4461/064 | MA-PD | $0 | $3,800 | 4.0 | 6 | 3,072 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 4.0 |
| C02 | Colorectal Cancer Screening | 4.0 |
| C03 | Annual Flu Vaccine | 2.0 |
| C04 | Improving or Maintaining Physical Health | 5.0 |
| C05 | Improving or Maintaining Mental Health | 1.0 |
| C06 | Monitoring Physical Activity | 2.0 |
| C07 | Special Needs Plan (SNP) Care Management | 4.0 |
| C08 | Care for Older Adults – Medication Review | 5.0 |
| C09 | Care for Older Adults – Pain Assessment | 4.0 |
| C10 | Osteoporosis Management in Women who had a Fracture | 3.0 |
| C11 | Diabetes Care – Eye Exam | 5.0 |
| C12 | Diabetes Care – Blood Sugar Controlled | 4.0 |
| C13 | Kidney Health Evaluation for Patients with Diabetes | 4.0 |
| C14 | Controlling High Blood Pressure | 4.0 |
| C15 | Reducing the Risk of Falling | 4.0 |
| C16 | Improving Bladder Control | 3.0 |
| C17 | Medication Reconciliation Post-Discharge | 4.0 |
| C18 | Plan All-Cause Readmissions | 3.0 |
| C19 | Statin Therapy for Patients with Cardiovascular Disease | 3.0 |
| C20 | Transitions of Care | 3.0 |
| C21 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3.0 |
| C22 | Getting Needed Care | 5.0 |
| C23 | Getting Appointments and Care Quickly | 5.0 |
| C24 | Customer Service | 4.0 |
| C25 | Rating of Health Care Quality | 5.0 |
| C26 | Rating of Health Plan | 5.0 |
| C27 | Care Coordination | 5.0 |
| C28 | Complaints about the Health Plan | 4.0 |
| C29 | Members Choosing to Leave the Plan | 4.0 |
| C30 | Health Plan Quality Improvement | 3.0 |
| C31 | Plan Makes Timely Decisions about Appeals | 3.0 |
| 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 | 2.0 |
| D05 | Rating of Drug Plan | 5.0 |
| D06 | Getting Needed Prescription Drugs | 5.0 |
| D07 | MPF Price Accuracy | 1.0 |
| D08 | Medication Adherence for Diabetes Medications | 2.0 |
| D09 | Medication Adherence for Hypertension (RAS antagonists) | 3.0 |
| D10 | Medication Adherence for Cholesterol (Statins) | 3.0 |
| D11 | MTM Program Completion Rate for CMR | 3.0 |
| D12 | Statin Use in Persons with Diabetes (SUPD) | 3.0 |