Humana Gold Choice H8145-052 (PFFS) 2025 Plan Details for Campbell County, Kentucky Residents
Humana Gold Choice H8145-052 (PFFS) 2025 Plan Details for Campbell County, Kentucky Residents
Navigating your Medicare Advantage options in Campbell County for 2025 can be overwhelming, but we're here to help. With Humana Gold Choice H8145-052 (PFFS) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Humana Gold Choice H8145-052 Overview
Plan ID H8145-052-0 Overview | |
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Health Plan ID: | H8145-052-0 |
Medicare Advantage Plan Type: | PFFS |
Plan Year: | 2024 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Enhanced, $360.00 deductible |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | Campbell County, KY |
Insured By: | Humana |
Explore Humana Gold Choice H8145-052 Benefits
Humana Gold Choice H8145-052 is a Medicare Advantage Prescription Drug (MAPD) Private Fee-for-Service (PFFS) plan that provides flexibility and comprehensive healthcare coverage. With a monthly premium of $0.00, this plan includes all the essential benefits of Medicare Part A and Part B, plus additional services like prescription drug coverage. The annual Part D deductible is $360.00. As a PFFS plan, you can choose any Medicare-approved provider who agrees to the plan’s payment terms, offering you more options for your healthcare needs.
Humana Gold Choice H8145-052 also provides financial protection with an annual maximum out-of-pocket (MOOP) limit of . Once you reach this limit, the plan covers 100% of your covered healthcare costs for the rest of the year. This feature makes Humana Gold Choice H8145-052 a reliable choice for those seeking a plan that combines flexibility in provider choice with comprehensive coverage and predictable costs.
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Out-of-Pocket Costs
Humana Gold Choice H8145-052 has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H8145-052-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $45 Copay |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $45 Copay |
Routine Foot Care: | $40 Copay |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $15 Copay |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $90 Copay |
Urgent care: | $55 Copay |
Ground ambulance: | $290 Copay |
Inpatient hospital care: | $325.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient hospital care: | $275 Copay |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $184.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $40 Copay |
Outpatient group therapy: | $40 Copay |
Inpatient psychiatric hospital care: | $325.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy: | $40 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $40 Copay |
Occupational therapy: | $40 Copay |
Medical Equipment and Supplies (In-Network) | |
Diabetes supplies: | 20% Coinsurance |
Durable medical equipment: | 20% Coinsurance |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging (In-Network) | |
Diagnostic radiology services: | $300 Copay |
Lab services: | $55 Copay |
Outpatient x-rays: | $105 Copay |
Diagnostic tests and procedures: | $105 Copay |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Most preventive services are covered 100% by Humana Gold Choice H8145-052 as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that Humana offers with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | $0 Copay Limitations Apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay |
Vision | Maximum vision benefit: | $100.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
Humana Gold Choice H8145-052 includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
While the prescription drug plan (Part D) premium is included in the overall plan cost, some plans may have additional costs or provide assistance through the Low-Income Subsidy (LIS) program. Also known as Extra Help, LIS is a Social Security program that assists individuals with limited income and resources in reducing or eliminating Part D expenses.
The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $0.00 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $0.00 |
Part D Premium with Full LIS Assistance: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $360.00. You must pay this amount at the pharmacy before Humana begins paying its share.
NOTE: The deductible does not apply to one or more drug tiers in this plan (see "Prescription Drug Plan Out-of-Pocket Costs" below).
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Humana Gold Choice H8145-052 has out-of-pocket costs that you must pay when you pick up your prescriptions.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | N/A | $7.00 copay (deductible does not apply) |
2 (Generic) | N/A | $17.00 copay |
3 (Preferred Brand) | N/A | $47.00 copay |
4 (Non-Preferred Drug) | N/A | $100.00 copay |
5 (Specialty Tier) | N/A | 27% |
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
CMS Measure | Star Rating |
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2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Who Can Enroll in Humana Gold Choice H8145-052?
To enroll in Humana Gold Choice H8145-052, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
- Not have End-Stage Renal Disease (ESRD), with some exceptions.
If you meet these requirements, you are eligible to enroll in Humana Gold Choice H8145-052 and benefit from its comprehensive coverage options.
When Can I Enroll in Humana Gold Choice H8145-052?
To ensure you don’t miss your chance to enroll in Humana Gold Choice H8145-052, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) to get assistance from a licensed insurance agent.
How to Sign Up for Humana Gold Choice H8145-052
Getting started with Humana Gold Choice H8145-052 is simple. Here are your options:
- Online Enrollment: Easily enroll online using a secure form. Visit the MedicareEnrollment.com enrollment page and follow the steps to complete your enrollment.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent will guide you through the process and answer any questions.
- Through Medicare.gov: Enroll through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the instructions to join a Medicare Advantage plan.
- Directly with the Plan: You can also enroll directly with Humana Gold Choice H8145-052. The plan's contact information is available below in the "Contact" section.
Be sure to enroll during the appropriate period to ensure your coverage begins without delay.
Contact Humana
Website: | http://www.humana.com/medicare |
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Formulary: | https://www.humana.com/pharmacy/ |
Pharmacy: | Humana Pharmacy Page |
New Members: | (800)833-2364 |
TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
This page was last updated on .