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Humana Dual Select H2875-006 (HMO-POS D-SNP) Costs & Coverage — Orange County, Virginia

CMS Rating:☆☆☆☆☆(0.0 out of 5 stars*)

CMS Plan-ID H2875-006-0 identifies Humana Dual Select H2875-006 (HMO-POS D-SNP), a Dual-Eligible Medicare Special Needs Plan offered by Humana for the 2026 plan year.

The most recent CMS enrollment data shows an estimated 3,960 beneficiaries enrolled in this plan, with 36 in Orange County.

Last update:

Humana Dual Select H2875-006 Overview

2026 Medicare Special Needs Plan Overview for H2875-006-0
Plan Overview for H2875-006-0
CMS Plan ID: H2875-006-0
Plan Type: HMO-POS D-SNP
Plan Year: 2026
Monthly Premium: $21.80
Plus your Medicare Part B premium.
Medical Deductible: $0.00
Maximum Out-of-Pocket: $9250.00 (In-Network)
Part B Give Back: Not offered
Prescription Drug Coverage: Enhanced, $615.00 deductible
Additional Benefits: Dental, Vision, Hearing
Service Area: Orange County, VA
Enrollment (Nationwide): 3,960 beneficiaries
Enrollment (CMS – Local)36 beneficiaries in Orange County
Provided By: Humana
If you qualify for Original Medicare and a Medicare Advantage Plan but don't know where to begin, our HealthCompare licensed insurance agents[1] are available at 1-833-748-3201 (TTY 711) to answer your questions (M-F 8AM-10PM, Sat 9AM-8PM EST) and help you enroll. There's no obligation.

To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).

Eligibility and Plan Network

Eligibility Requirements

Humana Dual Select H2875-006 is a Dual Eligible Special Needs Plan (D-SNP) designed for individuals enrolled in both Medicare and Medicaid.

Eligibility requirements for Humana Dual Select H2875-006 (H2875-006-0)
Special Needs Plan Type: Dual-Eligible Special Needs Plan (D-SNP)
Medicare Requirement: Medicare Part A and Part B
Special Needs Requirement: Must qualify for Medicaid
Service Area Requirement: Must live in the plan's service area
Prescription Drug Coverage: Prescription drug coverage (Part D) is included.

Plan Network

This plan uses an HMO-POS network, meaning most care is provided by in-network doctors and facilities. Referrals are typically required for specialist visits, but some out-of-network services may be covered at a higher cost. Emergency care and out-of-area dialysis are covered.

CMS Rating Marks

The Centers for Medicare & Medicaid Services (CMS) annually rates Medicare Advantage HMO-POS D-SNPs in nine key categories using a 5-star system. These ratings help you gauge the quality of care and service you might receive with this Humana plan.

2026 Medicare Star Ratings for Contract H2875
CMS Measure Star Rating
2026 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines Plan too new to be measured
Managing Chronic (Long Term) Conditions Plan too new to be measured
Member Experience with Health Plan Plan too new to be measured
Complaints and Changes in Plans Performance Plan too new to be measured
Health Plan Customer Service Plan too new to be measured
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan Plan too new to be measured
Member Experience with the Drug Plan Plan too new to be measured
Drug Safety and Accuracy of Drug Pricing Plan too new to be measured

Covered Services & Costs

Office Visits

This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.

Primary care and specialist visit costs for this plan.
Covered Service In-Network Cost
Primary: In-network: $0 copay
Specialist: In-network: $0 or $25 copay

Preventive and Wellness Services

Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.

Preventive and wellness service costs and benefits for this plan.
Covered Service In-Network Cost
Annual wellness exam: In-network: $0 copay
Telehealth benefit: In-network: $0 or $0-$40 copay
Routine chiropractic: In-network: $0 copay
Fitness benefits: In-network: $0 copay
Health education: Not covered
Counseling services: Not covered
Over-the-counter drug benefits: In-network: $0 copay
Health transportation (non-emergency): Not covered

Diagnostic, Lab, and Imaging Services

Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.

Diagnostic, laboratory, and imaging service costs for this plan.
Covered Service In-Network Cost
Diagnostic radiology services: In-network: $0 or $0-$335 copay
Lab services: In-network: $0 or $0-$50 copay
Outpatient x-rays: In-network: $0 or $0-$125 copay
Diagnostic tests and procedures: In-network: $0 or $0-$120 copay, 0% or 20% coinsurance

Emergency and Urgent Care Services

Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, hospital stays, and skilled nursing facility care.

Emergency, urgent care, hospital, ambulance, and skilled nursing costs for this plan.
Covered Service In-Network Cost
Emergency room care: $0 or $115 copay
Worldwide emergency care: $115 copay
Urgent care: $0 or $40 copay
Inpatient hospital care: In-network: | Tier 1 | $0 or $399 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay
Skilled Nursing Facility: In-network: | Tier 1 | $0 per day for days 1-20 | $0 or $218 per day for days 21-100
Ground ambulance: In-network: $0 or $335 copay

Mental Health Services

Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.

Mental health therapy and inpatient psychiatric care costs for this plan.
Covered Service In-Network Cost
Outpatient individual therapy: In-network: $0 or $35 copay
Outpatient group therapy: In-network: $0 or $35 copay
Inpatient psychiatric hospital care: In-network: | Tier 1 | $0 or $399 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay

Rehabilitation Services

Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.

Physical, speech, and occupational therapy costs for this plan.
Covered Service In-Network Cost
Physical therapy and speech and language therapy: In-network: $0 or $25 copay
Occupational therapy: In-network: $0 or $25 copay

Medical Equipment and Supplies

Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.

Diabetes supplies, durable medical equipment, and prosthetic costs for this plan.
Covered Service In-Network Cost
Diabetes supplies: In-network: $0 copay, 0% or 20% coinsurance
Durable medical equipment: In-network: $0 copay, 0% or 20% coinsurance
Prosthetics: In-network: 0% or 20% coinsurance

Medicare Part B Drugs

Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.

Chemotherapy and other Medicare Part B-covered drug costs for this plan.
Covered Service In-Network Cost
Chemotherapy: In-network: 0% or 0%-20% coinsurance
Other Part B drugs (Medicare-covered): In-network: $0 copay, 0% or 0%-20% coinsurance

Dental Services

Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.

Preventive and comprehensive dental service costs for this plan.
Covered Service In-Network Cost
Oral exam: In-network: $0 copay | Out-of-network: $0 copay
Dental x-rays: In-network: $0 copay | Out-of-network: $0 copay
Cleaning: In-network: $0 copay | Out-of-network: $0 copay
Periodontics: In-network: $0 copay | Out-of-network: $0 copay
Endodontics: In-network: $0 copay | Out-of-network: $0 copay
Restorative services: In-network: $0 copay | Out-of-network: $0 copay
Implant services: Not covered
Orthodontics: Not covered
Oral/Maxillofacial surgery: In-network: $0 copay | Out-of-network: $0 copay

Vision Services

Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.

Routine eye exams, contact lenses, and eyewear costs for this plan.
Covered Service In-Network Cost
Routine eye exam: In-network: $0 copay
Contact lenses: In-network: $0 copay
Eyeglass frames only: Not covered
Eyeglass lenses only: Not covered
Eyeglasses (frames & lenses): In-network: $0 copay
Upgrades: Not covered

Hearing Services

Hearing coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.

Hearing exams, fittings, and hearing aid costs for this plan.
Covered Service In-Network Cost
Hearing exam: In-network: $0 copay
Fitting/evaluation: In-network: $0 copay
Prescription hearing aids: In-network: $0 copay
OTC hearing aids: In-network: $0 copay

Additional and Special Needs Services

Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.

Additional and special needs service costs and benefits for this plan.
Covered Service In-Network Cost
Adult day health services: Not covered
Home-based palliative care: Not covered
Personal emergency response system: Not covered
Weight management programs: Not covered
Wigs for chemotherapy-related hair loss: Not covered
Alternative therapies: Not covered
Massage therapy: Not covered
Home/bathroom safety devices: Not covered

Humana Dual Select H2875-006 covers 100% of certain preventive services as a required Part B benefit.

Prescription Drug Coverage

Part D Coverage Level (Benefit Design)

Humana Dual Select H2875-006 includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.

Plan Premium

The following table outlines the prescription drug plan premium details of this plan.

Medicare Part D Premium Breakdown for Humana Dual Select H2875-006 (HMO-POS D-SNP)
Part D Premium Component Amount
Basic Part D Premium: $21.80
Supplemental Part D Premium: $0.00
Total Part D Premium: $21.80
Low Income Premium Subsidy: $24.56
Low Income Premium Subsidy CMS Pays: $21.80
Low Income Subsidy Premium: $0.00

For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.

Plan Deductible

The Medicare Part D annual deductible with this plan is $615.00. This is the amount you must pay at the pharmacy before Humana begins paying its share.

Out-of-Pocket Costs

In addition to the plan's monthly premium and deductible, Humana Dual Select H2875-006 has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.

Prescription Drug Tier Pricing for Humana Dual Select H2875-006 (HMO-POS D-SNP)
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayComing soon
Generic$0.00 copayComing soon
Preferred Brand25% coinsuranceComing soon
Non-Preferred Drug25% coinsuranceComing soon
Specialty Tier25% coinsuranceComing soon
*Deductible does not apply.

Contact Humana

Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .

Humana Plan Contact Details for Humana Dual Select H2875-006 (HMO-POS D-SNP)
Contact Type Details
Website: Humana Plan Page
New Members: 1-888-873-0686
Existing Members: 1-800-457-4708
Plan Address: 101 E Main Street | Louisville, KY 40202
Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
Primary CMS datasets used to compile information about Plan ID H2875-006-0
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services 202608
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2026
Plan Benefits Package Centers for Medicare & Medicaid Services 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-08
Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Humana (official source) http://www.humana.com/medicare October 13, 2025
CMS.gov Dual Eligible Special Needs Plans (D-SNPs) September 20, 2025
Medicare.gov Compare types of Medicare Advantage Plans 25 May, 2025
AARP.org The Big Choice: Original Medicare vs. Medicare Advantage 5 May, 2025

Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.

Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.