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Humana Gold Choice H8145-006 (PFFS)

Humana Inc.
Humana Gold Choice H8145-006 (PFFS) H8145-006 Plan Details
4 out of 5 stars

Humana Gold Choice H8145-006 (PFFS) is a PFFS Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H8145-006

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$38.00
Monthly Premium

Humana Gold Choice H8145-006 (PFFS) is a PFFS Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H8145-006

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Humana Inc.
Humana Gold Choice H8145-006 (PFFS) H8145-006 Plan Details
4 out of 5 stars

Humana Gold Choice H8145-006 (PFFS) is a PFFS Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H8145-006

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$38.00
Monthly Premium

Illinois Counties Served

Mclean Iroquois Lee Kendall La Salle Grundy Kankakee Winnebago Ogle Boone Kane Mchenry Cook Hardin Pope Johnson Union Gallatin Sangamon Edwards White Wayne Richland Wabash Lawrence Crawford Washington Clinton Pike Saint Clair Bond Madison Clark Douglas Greene Montgomery Dewitt Logan Mason Tazewell Schuyler Peoria Knox Bureau Rock Island Stephenson Carroll Jo Daviess

Iowa Counties Served

Burt Audubon Calhoun Carroll Van Buren Louisa Harrison Dickinson Lyon Cherokee Sioux Ida Adams Sac Buena Vista Pocahontas Webster Emmet

Kansas Counties Served

Mitchell Chase Phillips Lyon Riley Smith Norton Jewell

Michigan Counties Served

Delta Kalamazoo Van Buren Saint Joseph Allegan Berrien Cass Hillsdale Lenawee Muskegon Ottawa Wexford Antrim Kalkaska Dickinson Menominee Barry Marquette Houghton Shiawassee Kent Montcalm Eaton Calhoun

Minnesota Counties Served

Dodge Freeborn Mower Blue Earth Winona Olmsted Roberts Nicollet Brown Sibley Waseca Rice Steele Goodhue Faribault Martin Fillmore Houston Deuel

Missouri Counties Served

Polk Holt Atchison Grundy Mercer Vernon Newton Saint Clair Benton Henry Lawrence Jasper Cedar Dade Barry Boone Miller Camden Cole Ozark Greene Hickory Phelps Pulaski Laclede Wright Dallas Christian Dekalb Stone Taney Douglas Callaway Montgomery Saint Louis Jefferson Crawford Saint Louis City Saint Charles Pike Ralls Lewis Reynolds Macon Marion Chariton Mississippi Carter Bollinger Perry Stoddard Pemiscot Butler Jackson Platte Clay Carroll

Montana Counties Served

Lincoln Mckenzie Pondera Judith Basin Teton Chouteau Cascade Rosebud Carbon Silver Bow Ravalli Flathead Park

North Dakota Counties Served

Burleigh

Oklahoma Counties Served

Atoka Mccurtain Choctaw

South Dakota Counties Served

Yankton Hanson Davison Union

Wisconsin Counties Served

Waukesha Dodge Washington Sheboygan Ozaukee Winnebago Trempealeau Vilas Clark Eau Claire Marathon Waupaca Langlade Brown Outagamie Shawano Forest Oneida Adams Juneau Green Lake Marquette Sauk Richland Dane Lafayette Milwaukee Walworth Racine Kenosha Jefferson Manitowoc Fond Du Lac

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $590
Out of Pocket Max In-Network: $-1
Out-of-Network: N/A
Initial Coverage Limit $2000
Catastrophic Coverage Limit $2,000
Primary Care Doctor Visit
In-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0
Out-of-Network:

Doctor Office Visit Services:
Copayment for Medicare Covered Primary Care Office Visit $0
Specialty Doctor Visit
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $55
Out-of-Network:

Doctor Specialty Visit Services:
Copayment for Medicare Covered Physician Specialist Office Visit $55
Inpatient Hospital Care
In-Network:

Acute Hospital Services:
$230 per day for days 1 to 7
$0 per day for days 8 to 90
Out-of-Network:

Acute Hospital Services:
$230 per day for days 1 to 7
$0 per day for days 8 to 90
Urgent Care
Copayment for Urgent Care $45

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $110
Emergency Room Visit
Copayment for Emergency Care $110

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $110
Copayment for Worldwide Emergency Transportation $110
Ambulance Transportation
In-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $315

Air Ambulance:
Coinsurance for Air Ambulance Services 20%
Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $315
Coinsurance for Medicare Covered Ambulance Services - Air 20%

Health Care Services and Medical Supplies

Humana Gold Choice H8145-006 (PFFS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network:
Copayment for Medicare-covered Chiropractic Services $15
Out-of-Network:

Medicare Covered Chiropractic Services:
Copayment for Medicare Covered Chiropractic Services $15
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network:
Copayment for Medicare-covered Diabetic Supplies $0
Coinsurance for Medicare-covered Diabetic Supplies 10%
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $0
Out-of-Network:

Medicare Covered Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 10%
Copayment for Medicare Covered Diabetic Therapeutic Shoes or Inserts $0
Durable Medical Eqipment (DME)
In-Network:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Out-of-Network:

Medicare Covered Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 20%
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $0 to $95
Copayment for Medicare-covered Lab Services $0 to $55
$95 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$55 OP Diag Proc & Tests - SPC$45 OP Diag Proc & Tests - UCC$95 Sleep Study (Fac Based) - OPH$55 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home_

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $0 to $350
Coinsurance for Medicare-covered Diagnostic Radiological Services 20%
Coinsurance for Medicare-covered Therapeutic Radiological Services 20%
Copayment for Medicare-covered X-Ray Services $0 to $150
Out-of-Network:

Medicare Covered Diagnostic Procedures/Tests Services:
Copayment for Medicare Covered Diagnostic Procedures/Tests
$0 to $95
Copayment for Medicare Covered Lab Services
$0 to $55
Copayment for Medicare Covered Diagnostic Radiological Services $0 to $350
Coinsurance for Medicare Covered Diagnostic Radiological Services 20%
Coinsurance for Medicare Covered Therapeutic Radiological Services 20%
Copayment for Medicare Covered Outpatient X-Ray Services $0 to $150
$95 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$55 OP Diag Proc & Tests - SPC$45 OP Diag Proc & Tests - UCC$95 Sleep Study (Fac Based) - OPH$55 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home_
Home Health Care
In-Network:
Copayment for Medicare-covered Home Health Services $0
Out-of-Network:

Medicare Covered Home Health Services:
Copayment for Medicare Covered Home Health $0
Mental Health Inpatient Care
In-Network:

Psychiatric Hospital Services:
$230 per day for days 1 to 7
$0 per day for days 8 to 90
Out-of-Network:

Psychiatric Hospital Services:
$230 per day for days 1 to 7
$0 per day for days 8 to 90
Mental Health Outpatient Care
In-Network:
Copayment for Medicare-covered Individual Sessions $45
Copayment for Medicare-covered Group Sessions $45
Out-of-Network:

Medicare Covered Mental Health Services:
Copayment for Medicare Covered Individual Sessions $45
Copayment for Medicare Covered Group Sessions $45
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $350
$0 Diag Colonoscopy - OPH$95 Mental Health - OPH$350 Surgery Svcs - OPH$55 Wound Care - OPH_

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $230

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0 to $300
$0 Diag Colonoscopy - ASC$300 Surgery Svcs - ASC_
Out-of-Network:

Medicare Covered Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $350
Copayment for Medicare Covered Ambulatory Surgical Center Services $0 to $300
$0 Diag Colonoscopy - OPH$95 Mental Health - OPH$350 Surgery Svcs - OPH$55 Wound Care - OPH_
Outpatient Substance Abuse Care
In-Network:
Copayment for Medicare-covered Individual Sessions $45 to $95
Copayment for Medicare-covered Group Sessions $45 to $95
$95 OP Substance Abuse Care - OPH$45 OP Substance Abuse Care - SPC_
Out-of-Network:

Medicare Covered Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $45 to $95
Copayment for Medicare Covered Group Sessions $45 to $95
$95 OP Substance Abuse Care - OPH$45 OP Substance Abuse Care - SPC_
Podiatry Services
In-Network:
Copayment for Medicare-Covered Podiatry Services $55
Out-of-Network:

Medicare Covered Podiatry Services:
Copayment for Medicare Covered Podiatry Services $55
Skilled Nursing Facility Care
In-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$203 per day for days 21 to 100
Out-of-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$203 per day for days 21 to 100

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
Plan covers up to $3000 allowance every year for non-Medicare covered preventive and comprehensive dental services. You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire.
Your benefit can be used for most dental treatments such as:
Preventive dental services, such as exams, routine cleanings, etc.
Basic dental services, such as fillings, extractions, etc.
Major dental services, such as periodontal scaling, crowns, dentures, root canals, bridges etc.
30% coinsurance applies to dentures.
30% - 40% coinsurance applies to bridges and crowns.
Frequency limits may apply.
Note: The allowance cannot be used on fluoride, cosmetic services and implants.
Out of Network
Plan covers up to $3000 allowance every year for non-Medicare covered preventive and comprehensive dental services. You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire.
Your benefit can be used for most dental treatments such as:
Preventive dental services, such as exams, routine cleanings, etc.
Basic dental services, such as fillings, extractions, etc.
Major dental services, such as periodontal scaling, crowns, dentures, root canals, bridges etc.
30% coinsurance applies to dentures.
30% - 40% coinsurance applies to bridges and crowns.
Frequency limits may apply.
Note: The allowance cannot be used on fluoride, cosmetic services and implants.
Benefits received out-of-network are subject to any in-network benefit maximums, limitations, and/or exclusions.

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In-Network:

Eye Exams:
Copayment for Medicare Covered Benefits $0 to $55
Copayment for Routine Eye Exams $0
  • Maximum 1 Routine Eye Exam every year
Maximum Plan Benefit of $75 every year

Eyewear:
Copayment for Medicare-Covered Benefits $0
Copayment for Contact Lenses $0
  • Maximum 1 Pair every year
Copayment for Eyeglasses (lenses and frames) $0
  • Maximum 1 Pair every year
Maximum Plan Benefit of $100 every year
Members must use Humana's Medicare Insight Network, a national network of providers, which includes standard or PLUS providers. The allowance for the standard network is $50 less than the PLUS network.
Out-of-Network:

Medicare Covered Eye Exams Services:
Copayment for Medicare Covered Eye Exams $0 to $55
Copayment for Medicare Covered Eyewear $20

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $55
Copayment for Routine Hearing Exams $0
  • Maximum 1 visit every year
Copayment for Fitting/Evaluation for Hearing Aid $0

Hearing Aids:
Copayment for Hearing Aids $699 to $999
  • Maximum 2 Hearing Aids every year
Out-of-Network:

Medicare Covered Hearing Exams Services:
Copayment for Medicare Covered Hearing Exams $55

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
    • Tobacco use cessation
    Yearly "Wellness" visit
    Out-of-Network:

    Medicare Covered Medicare-covered Preventive Services:
    Copayment for Medicare Covered Medicare-covered Preventive Services $0

    Prescription Drug Costs and Coverage

    The Humana Gold Choice H8145-006 (PFFS) plan offers the following prescription drug coverage, with an annual drug deductible of $590 (excludes Tiers 1 and 2) per year.

    Coverage
    Cost
    Coverage & Cost
    Annual Drug Deductible $590 (excludes Tiers 1 and 2)
    Preferred Generic
    • Standard mail order $10.00
    • Standard retail $6.00
    • Preferred cost-share mail order $6.00
    Generic
    • Standard mail order $20.00
    • Standard retail $15.00
    • Preferred cost-share mail order $15.00
    Annual Drug Deductible $590 (excludes Tiers 1 and 2)
    Preferred Generic
    • Standard mail order N/A
    • Standard retail N/A
    • Preferred cost-share mail order N/A
    Generic
    • Standard mail order N/A
    • Standard retail N/A
    • Preferred cost-share mail order N/A
    Annual Drug Deductible $590 (excludes Tiers 1 and 2)
    Preferred Generic
    • Standard mail order $30.00
    • Standard retail $18.00
    • Preferred cost-share mail order $0.00
    Generic
    • Standard mail order $60.00
    • Standard retail $45.00
    • Preferred cost-share mail order $0.00
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