H5619-075 (HMO D-SNP) 
As amember of this plan, you will not be responsible  
for cost sharing for plan benefits. The Medicaid  
Comparison Chart shows specific benefits that  
Medicaid may cover for some dual eligible members.  
You will work with your Humana care coordinator to  
understand and access these benefits from the  
Kentucky Department of Medicaid Services (DMS)  
after any Humana Gold Plus SNP-DE H5619-075 (HMO  
D-SNP) benefits are used. The Covered Medical and