Humana Gold Choice H8145-126 (PFFS) H8145-126-0 Plan Details
Humana Gold Choice H8145-126 (PFFS) H8145-126-0 Plan Details
Navigating your Medicare Advantage options for 2025 can be overwhelming, but we're here to help. With Humana Gold Choice H8145-126 (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 H8145-126 Overview
Plan ID H8145-126-0 Overview | |
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Health Plan ID: | H8145-126-0 |
Medicare Advantage Plan Type: | PFFS |
Plan Year: | 2024 |
Monthly Premium: | $15.00 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: | Not Included |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Humana |
Why Consider Humana Gold Choice H8145-126?
Humana Gold Choice H8145-126 is a Medicare Advantage Private Fee-for-Service (PFFS) plan that offers comprehensive and flexible healthcare coverage. With a monthly premium of $15.00, this plan provides the core benefits of Medicare Part A and Part B, ensuring you have access to essential medical care. As a PFFS plan, Humana Gold Choice H8145-126 allows you to choose any Medicare-approved provider who accepts the plan’s payment terms, giving you the freedom to access care that fits your needs.
It’s important to note that Humana Gold Choice H8145-126 does not include Medicare drug coverage. For prescription drug needs, explore standalone Part D plans. A key advantage of Humana Gold Choice H8145-126 is its financial protection through 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 makes Humana Gold Choice H8145-126 an ideal choice for those who value flexibility and comprehensive coverage.
We're Here to Help You Enroll |
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Out-of-Pocket Costs
Humana Gold Choice H8145-126 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 H8145-126-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $5 Copay |
Specialist: | $40 Copay |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $40 Copay |
Routine Foot Care: | Not Covered |
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: | $265 Copay |
Inpatient hospital care: | $360.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital care: | $225 Copay |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $172.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $30 Copay |
Outpatient group therapy: | $30 Copay |
Inpatient psychiatric hospital care: | $360.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
Outpatient group therapy: | $30 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $25 Copay |
Occupational therapy: | $25 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: | $55 Copay |
Outpatient x-rays: | $55 Copay |
Diagnostic tests and procedures: | $55 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 H8145-126 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
This plan does not include a Medicare Part D plan for prescriptions.
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 |
Plan Availability
Humana Gold Choice H8145-126 (H8145-126-0) is available in the following locations (click to open):
Am I Eligible for Humana Gold Choice H8145-126?
To enroll in Humana Gold Choice H8145-126, 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 H8145-126 and benefit from its comprehensive coverage options.
When Can I Enroll in Humana Gold Choice H8145-126?
To ensure you don’t miss your chance to enroll in Humana Gold Choice H8145-126, 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 H8145-126
Enrolling in Humana Gold Choice H8145-126 is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Humana Gold Choice H8145-126 through the official Medicare website.
- Directly with Humana Gold Choice H8145-126: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
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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