Humana Gold Choice H8145-122 (PFFS) H8145-122-0 Plan Details
Humana Gold Choice H8145-122 (PFFS) H8145-122-0 Plan Details
When selecting a Medicare Advantage plan for 2025, it's important to compare all your options. Humana Gold Choice H8145-122 (PFFS) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Humana Gold Choice H8145-122 Overview
Plan ID H8145-122-0 Overview | |
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Health Plan ID: | H8145-122-0 |
Medicare Advantage Plan Type: | PFFS |
Plan Year: | 2024 |
Monthly Premium: | $132.00 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, $0.00 deductible |
Part D Gap Coverage: | Yes |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Humana |
Why Consider Humana Gold Choice H8145-122?
Humana Gold Choice H8145-122 is a Medicare Advantage Prescription Drug (MAPD) Private Fee-for-Service (PFFS) plan that delivers comprehensive healthcare benefits with flexibility. With a monthly premium of $132.00, this plan covers the core services of Medicare Part A and Part B, along with additional benefits like prescription drug coverage. There is no annual deductible. Cost sharing begins with your first prescription. As a PFFS plan, you have the freedom to visit any Medicare-approved provider who accepts the plan’s payment terms, giving you the ability to choose the care that best fits your needs.
A key advantage of Humana Gold Choice H8145-122 is the financial protection it offers, with an annual maximum out-of-pocket (MOOP) limit of . After reaching this limit, the plan covers 100% of your covered healthcare costs for the remainder of the year. This makes Humana Gold Choice H8145-122 an excellent option for those who value flexibility in their healthcare choices while benefiting from comprehensive coverage.
We're Here to Help You Enroll |
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Cost-Sharing Overview
Humana Gold Choice H8145-122 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 H8145-122-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $0 Copay |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $0 Copay |
Routine Foot Care: | Not Covered |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $0 Copay |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $95 Copay |
Urgent care: | $65 Copay |
Ground ambulance: | $0 Copay |
Inpatient hospital care: | $0.00 per stay |
Outpatient hospital care: | $0 Copay |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $196.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $0 Copay |
Outpatient group therapy: | $0 Copay |
Inpatient psychiatric hospital care: | $0.00 per stay |
Outpatient group therapy: | $0 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $0 Copay |
Occupational therapy: | $0 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: | 20% Coinsurance |
Lab services: | $65 Copay |
Outpatient x-rays: | $65 Copay |
Diagnostic tests and procedures: | $65 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 H8145-122 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: | $150.00 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 H8145-122 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: | $57.60 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $57.60 |
Part D Premium with Full LIS Assistance: | $17.80 |
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 $0.00. You must pay this amount at the pharmacy before Humana begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Humana Gold Choice H8145-122 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 | $0.00 copay |
2 (Generic) | N/A | $0.00 copay |
3 (Preferred Brand) | N/A | $47.00 copay |
4 (Non-Preferred Drug) | N/A | $99.00 copay |
5 (Specialty Tier) | N/A | 33% |
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
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 |
Plan Availability
Humana Gold Choice H8145-122 (H8145-122-0) is available in the following locations (click to open):
Am I Eligible for Humana Gold Choice H8145-122?
To qualify for enrollment in Humana Gold Choice H8145-122, you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
- Not have End-Stage Renal Disease (ESRD), except under certain conditions.
If you fulfill these criteria, you can enroll in Humana Gold Choice H8145-122 and enjoy the extensive healthcare benefits it offers.
Enrollment Periods for Humana Gold Choice H8145-122
Knowing when you can enroll in Humana Gold Choice H8145-122 is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) for expert guidance from a licensed insurance agent.
Steps to Enroll in Humana Gold Choice H8145-122
Joining Humana Gold Choice H8145-122 is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Humana Gold Choice H8145-122.
- Direct Enrollment: You can also choose to enroll directly with Humana Gold Choice H8145-122. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
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.
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