Humana Gold Choice H8145-061 (PFFS) is a Medicare Advantage (Part C) Plan by Humana.
This page features plan details for 2022 Humana Gold Choice H8145-061 (PFFS) H8145 – 061 – 0 available in Select Counties in Florida.
Humana Gold Choice H8145-061 (PFFS) is offered in the following locations.
Humana Gold Choice H8145-061 (PFFS) offers the following coverage and cost-sharing.
Insurer: | Humana |
Health Plan Deductible: | $0 |
MOOP: | $- |
Drugs Covered: | Yes |
Ready to sign up for Humana Gold Choice H8145-061 (PFFS) ?
Part B | Part C | Part D | Part B Give Back | Total |
---|---|---|---|---|
$170.10 | $47.40 | $54.60 | $0.00 | $272.10 |
Humana Gold Choice H8145-061 (PFFS) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
Drug Deductible: | $200.00 |
Initial Coverage Limit: | $4,430.00 |
Catastrophic Coverage Limit: | $7,050.00 |
Drug Benefit Type: | Enhanced |
Gap Coverage: | No |
Formulary Link: | Formulary Link |
Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
---|---|---|---|---|
$54.60 | $46.00 | $37.40 | $28.90 | $20.30 |
After you pay your $200.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,430.00. Once you reach that amount, you will enter the next coverage phase.
After your total drug costs (including what this plan has paid and what you have paid) reach $4,430.00, you will pay no more than the amounts below for any drug tier until you reach $7,050.00.
Drug Type | Cost Share |
---|---|
Generic drugs | 25% |
Brand-name drugs | 25% |
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,050.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
Drug Type | Cost Share |
---|---|
Generic drugs | $3.95 copay or 5% (whichever costs more) |
Brand-name drugs | $9.85 copay or 5% (whichever costs more) |
Humana Gold Choice H8145-061 (PFFS) also provides the following benefits.
In-Network: Yes, contact plan for further details |
Diagnostic services: | Not covered |
Endodontics: | Not covered |
Extractions: | In-Network: $25 copay (limits may apply) |
Extractions: | Out-of-Network: $25 copay or 50% coinsurance (limits may apply) |
Non-routine services: | In-Network: $25 copay (limits may apply) |
Non-routine services: | Out-of-Network: $25 copay or 50% coinsurance (limits may apply) |
Periodontics: | In-Network: $25 copay (limits may apply) |
Periodontics: | Out-of-Network: $25 copay or 50% coinsurance (limits may apply) |
Prosthodontics, other oral/maxillofacial surgery, other services: | In-Network: 50% coinsurance (limits may apply) |
Prosthodontics, other oral/maxillofacial surgery, other services: | Out-of-Network: $25 copay or 50% coinsurance (limits may apply) |
Restorative services: | In-Network: $25 copay or 50% coinsurance (limits may apply) |
Restorative services: | Out-of-Network: $25 copay or 50% coinsurance (limits may apply) |
Cleaning: | In-Network: $0 copay (limits may apply) |
Cleaning: | Out-of-Network: $0 copay (limits may apply) |
Dental x-ray(s): | In-Network: $0 copay (limits may apply) |
Dental x-ray(s): | Out-of-Network: $0 copay (limits may apply) |
Fluoride treatment: | In-Network: $0 copay (limits may apply) |
Fluoride treatment: | Out-of-Network: $0 copay (limits may apply) |
Oral exam: | In-Network: $0 copay (limits may apply) |
Oral exam: | Out-of-Network: $0 copay (limits may apply) |
Diagnostic radiology services (e.g., MRI): | In-Network: $40-150 copay or 20-25% coinsurance |
Diagnostic radiology services (e.g., MRI): | Out-of-Network: $40-150 copay or 20-25% coinsurance |
Diagnostic tests and procedures: | In-Network: $0-40 copay or 25% coinsurance |
Diagnostic tests and procedures: | Out-of-Network: $0-40 copay or 25% coinsurance |
Lab services: | In-Network: $0-40 copay or 25% coinsurance |
Lab services: | Out-of-Network: $0-40 copay or 25% coinsurance |
Outpatient x-rays: | In-Network: $5-40 copay or 20-25% coinsurance |
Outpatient x-rays: | Out-of-Network: $5-40 copay or 20-25% coinsurance |
Primary: | In-Network: $5 copay per visit |
Primary: | Out-of-Network: $5-40 copay or 20-25% coinsurance per visit |
Specialist: | In-Network: $40 copay per visit |
Specialist: | Out-of-Network: $40 copay per visit |
Emergency: | $90 copay per visit (always covered) |
Urgent care: | $5-40 copay per visit (always covered) |
Foot exams and treatment: | In-Network: $40 copay |
Foot exams and treatment: | Out-of-Network: $40 copay |
Routine foot care: | Not covered |
In-Network: $240 copay | |
Out-of-Network: $240 copay |
$0.00 |
In-Network: No |
Fitting/evaluation: | In-Network: $0 copay (limits may apply) |
Fitting/evaluation: | Out-of-Network: 50% coinsurance (limits may apply) |
Hearing aids: | In-Network: $0 copay (limits may apply) |
Hearing aids: | Out-of-Network: $0 copay (limits may apply) |
Hearing exam: | In-Network: $40 copay |
Hearing exam: | Out-of-Network: $40 copay |
In-Network: $290 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond | |
Out-of-Network: $290 per day for days 1 through 5 $0 per day for days 6 through 90 |
In-Network: $40-150 copay or 25% coinsurance per visit | |
Out-of-Network: $40-150 copay or 25% coinsurance per visit |
$6,700 In and Out-of-network |
Diabetes supplies: | In-Network: $0 copay or 20% coinsurance per item |
Diabetes supplies: | Out-of-Network: 20% coinsurance per item |
Durable medical equipment (e.g., wheelchairs, oxygen): | In-Network: 20% coinsurance per item |
Durable medical equipment (e.g., wheelchairs, oxygen): | Out-of-Network: 20% coinsurance per item |
Prosthetics (e.g., braces, artificial limbs): | In-Network: 20% coinsurance per item |
Prosthetics (e.g., braces, artificial limbs): | Out-of-Network: 20% coinsurance per item |
Chemotherapy: | In-Network: 20% coinsurance |
Chemotherapy: | Out-of-Network: 20% coinsurance |
Other Part B drugs: | In-Network: 20% coinsurance |
Other Part B drugs: | Out-of-Network: 20% coinsurance |
Inpatient hospital – psychiatric: | In-Network: $285 per day for days 1 through 5 $0 per day for days 6 through 90 |
Inpatient hospital – psychiatric: | Out-of-Network: $285 per day for days 1 through 5 $0 per day for days 6 through 90 |
Outpatient group therapy visit with a psychiatrist: | In-Network: $40 copay |
Outpatient group therapy visit with a psychiatrist: | Out-of-Network: $40 copay |
Outpatient group therapy visit: | In-Network: $40 copay |
Outpatient group therapy visit: | Out-of-Network: $40 copay |
Outpatient individual therapy visit with a psychiatrist: | In-Network: $40 copay |
Outpatient individual therapy visit with a psychiatrist: | Out-of-Network: $40 copay |
Outpatient individual therapy visit: | In-Network: $40 copay |
Outpatient individual therapy visit: | Out-of-Network: $40 copay |
No |
In-Network: $0 copay | |
Out-of-Network: $0 copay |
Occupational therapy visit: | In-Network: $40 copay or 20-25% coinsurance |
Occupational therapy visit: | Out-of-Network: $40-150 copay or 20-25% coinsurance |
Physical therapy and speech and language therapy visit: | In-Network: $40 copay or 20-25% coinsurance |
Physical therapy and speech and language therapy visit: | Out-of-Network: $40-150 copay or 20-25% coinsurance |
In-Network: $0 per day for days 1 through 20 $150 per day for days 21 through 100 | |
Out-of-Network: $0 per day for days 1 through 20 $150 per day for days 21 through 100 |
Not covered |
Contact lenses: | In-Network: $0 copay (limits may apply) |
Contact lenses: | Out-of-Network: $0 copay (limits may apply) |
Eyeglass frames: | Not covered |
Eyeglass lenses: | Not covered |
Eyeglasses (frames and lenses): | In-Network: $0 copay (limits may apply) |
Eyeglasses (frames and lenses): | Out-of-Network: $0 copay (limits may apply) |
Other: | Not covered |
Routine eye exam: | In-Network: $0 copay (limits may apply) |
Routine eye exam: | Out-of-Network: $0 copay (limits may apply) |
Upgrades: | Not covered |
Covered |
Ready to sign up for Humana Gold Choice H8145-061 (PFFS) ?
Get help enrolling in a Medicare Advantage or Medicare Prescription Drug Plan by calling a licensed insurance agent today.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
SMID: MULTIPLAN_HCIHNDOGMED01_M
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