HMO/HMOPOS · observed 2026 → 2026 · 75 months of CPSC history · 78 active CY 2025 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| Humana Gold Plus H5619-152 (HMO) H5619/152 | MA-PD | $0 | $9,350 | 3.5 | 41 | 36,765 |
| Humana Gold Plus H5619-049 (HMO-POS) H5619/049 | MA-PD | $0 | $4,500 | 3.5 | 63 | 31,870 |
| Humana Gold Plus H5619-057 (HMO) H5619/057 | MA-PD | $0 | $5,900 | 3.5 | 3 | 27,717 |
| Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP) H5619/054 · Dual-Eligible | SNP | $39 | $9,350 | 3.5 | 92 | 18,815 |
| Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP) H5619/156 · Dual-Eligible | SNP | $49 | $9,350 | 3.5 | 92 | 17,451 |
| Humana Dual Select H5619-075 (HMO D-SNP) H5619/075 · Dual-Eligible | SNP | $50 | $9,350 | 3.5 | 110 | 14,782 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H5619/161 · Chronic or Disabling Condition | SNP | $0 | $9,350 | 3.5 | 46 | 12,419 |
| Humana Gold Plus Giveback H5619-169 (HMO) H5619/169 | MA-PD | $0 | $9,350 | 3.5 | 41 | 11,616 |
| Humana Gold Plus H5619-071 (HMO) H5619/071 | MA-PD | $0 | $5,500 | 3.5 | 68 | 11,280 |
| Humana Gold Plus H5619-051 (HMO-POS) H5619/051 | MA-PD | $0 | $4,150 | 3.5 | 12 | 9,568 |
| Humana Gold Plus SNP-DE H5619-158 (HMO-POS D-SNP) H5619/158 · Dual-Eligible | SNP | $48 | $9,350 | 3.5 | 92 | 8,109 |
| Humana Gold Plus SNP-DE H5619-163 (HMO D-SNP) H5619/163 · Dual-Eligible | SNP | $50 | $9,350 | 3.5 | 115 | 8,030 |
| Humana Gold Plus SNP-DE H5619-003 (HMO D-SNP) H5619/003 · Dual-Eligible | SNP | $13 | $9,350 | 3.5 | 16 | 7,556 |
| Humana Gold Plus SNP-DE H5619-167 (HMO D-SNP) H5619/167 · Dual-Eligible | SNP | $26 | $9,350 | 3.5 | 31 | 7,508 |
| Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP) H5619/082 · Dual-Eligible | SNP | $38 | $9,350 | 3.5 | 46 | 7,482 |
| Humana Gold Plus H5619-113 (HMO-POS) H5619/113 | MA-PD | $0 | $8,550 | 3.5 | 44 | 6,391 |
| Humana Gold Plus H5619-091 (HMO) H5619/091 | MA-PD | $10 | $2,800 | 3.5 | 13 | 5,745 |
| Humana Gold Plus SNP-DE H5619-166 (HMO D-SNP) H5619/166 · Dual-Eligible | SNP | $13 | $9,350 | 3.5 | 31 | 5,330 |
| Humana Gold Plus H5619-095 (HMO) H5619/095 | MA-PD | $0 | $3,850 | 3.5 | 13 | 4,911 |
| Humana Gold Plus H5619-090 (HMO) H5619/090 | MA-PD | $79 | $2,000 | 3.5 | 13 | 4,776 |
| Humana Gold Plus H5619-174 (HMO) H5619/174 | MA-PD | $0 | $5,900 | 3.5 | 2 | 4,304 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H5619/164 · Chronic or Disabling Condition | SNP | $0 | $6,750 | 3.5 | 114 | 4,088 |
| Humana Dual Select H5619-165 (HMO D-SNP) H5619/165 · Dual-Eligible | SNP | $24 | $9,350 | 3.5 | 31 | 3,899 |
| Humana Gold Plus SNP-DE H5619-155 (HMO D-SNP) H5619/155 · Dual-Eligible | SNP | $20 | $9,350 | 3.5 | 2 | 3,812 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H5619/145 · Chronic or Disabling Condition | SNP | $19 | $9,350 | 3.5 | 118 | 3,531 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 3.0 |
| C02 | Colorectal Cancer Screening | 3.0 |
| C03 | Annual Flu Vaccine | 2.0 |
| C04 | Monitoring Physical Activity | 2.0 |
| C05 | Special Needs Plan (SNP) Care Management | 4.0 |
| C06 | Care for Older Adults � Medication Review | 4.0 |
| C07 | Care for Older Adults � Pain Assessment | 5.0 |
| C08 | Osteoporosis Management in Women who had a Fracture | 3.0 |
| C09 | Diabetes Care � Eye Exam | 4.0 |
| C10 | Diabetes Care � Blood Sugar Controlled | 4.0 |
| C11 | Controlling High Blood Pressure | 2.0 |
| C12 | Reducing the Risk of Falling | 3.0 |
| C13 | Improving Bladder Control | 3.0 |
| C14 | Medication Reconciliation Post-Discharge | 4.0 |
| C15 | Plan All-Cause Readmissions | 3.0 |
| C16 | Statin Therapy for Patients with Cardiovascular Disease | 3.0 |
| C17 | Transitions of Care | 4.0 |
| C18 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3.0 |
| C19 | Getting Needed Care | 3.0 |
| C20 | Getting Appointments and Care Quickly | 4.0 |
| C21 | Customer Service | 3.0 |
| C22 | Rating of Health Care Quality | 4.0 |
| C23 | Rating of Health Plan | 3.0 |
| C24 | Care Coordination | 3.0 |
| C25 | Complaints about the Health Plan | 4.0 |
| C26 | Members Choosing to Leave the Plan | 3.0 |
| C27 | Health Plan Quality Improvement | — |
| C28 | Plan Makes Timely Decisions about Appeals | 4.0 |
| C29 | Reviewing Appeals Decisions | 3.0 |
| C30 | Call Center � Foreign Language Interpreter and TTY Availability | 4.0 |
| D01 | Call Center � Foreign Language Interpreter and TTY Availability | 4.0 |
| D02 | Complaints about the Drug Plan | 4.0 |
| D03 | Members Choosing to Leave the Plan | 3.0 |
| D04 | Drug Plan Quality Improvement | — |
| D05 | Rating of Drug Plan | 4.0 |
| D06 | Getting Needed Prescription Drugs | 4.0 |
| D07 | MPF Price Accuracy | 1.0 |
| D08 | Medication Adherence for Diabetes Medications | 3.0 |
| 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 |