Humana Gold Choice H8145-120 (PFFS) By Humana Insurance Company
Humana Gold Choice H8145-120 (PFFS) is a 2015 Medicare Advantage ("Part C" or "MA Plan") plan by Humana Insurance Company. This plan from Humana Insurance Company works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for Humana Gold Choice H8145-120 (PFFS) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Humana Insurance Company and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
2015 Medicare Advantage Plan Details
| Plan Name: | Humana Gold Choice H8145-120 (PFFS) |
|---|---|
| Plan ID: | H8145-120 |
| Provider: | Humana Insurance Company |
| Plan Year: | 2015 |
| Plan Type: | PFFS * |
| Monthly Premium C+D: | $15.00 |
| MOOP: | N/A |
Coverage Area for Humana Gold Choice H8145-120 (PFFS)
(Click county to compare all available plans)
The Humana Gold Choice H8145-120 (PFFS) H8145-120 is available to residents in Arkansas, Colorado, Kansas, Missouri, Oklahoma, and has a in-network Maximum Out-of-Pocket limit of N/A MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in Humana Gold Choice H8145-120 (PFFS) plan you will stop paying co-pays for the rest of the year once you pay out of pocket N/A This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.
Humana Gold Choice H8145-120 (PFFS) is a PFFS *. A Private Fee-For-Service (PFFS) plan is a Medicare Advantage (MA) health plan offered by a contract with the Centers for Medicare & Medicaid Services (CMS) to provide you with benefits. Humana Insurance Company (instead of Medicare) will decide on how much it will cover and how much you will pay for the services you get. You may go to any Medicare approved doctor or hospital or any other health care provider that accepts both Medicare and your plans payment. A PFFS plan has no provider network, and you dont need a referral or a primary care physician for any health care or services. PFFS plans are the most flexible but a doctor will make a visit-by-visit decisions on whether to accept your provider.
Ratings for Humana Gold Choice H8145-120 (PFFS) H8145
| 2015 Overall Rating | ||
|---|---|---|
| Part C Summary Rating | ||
| Part D Summary 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 |
Member Experience with Health Plan
| Total Experience Rating | ||
|---|---|---|
| Getting Needed Care | ||
| Timely Care and Appointments | ||
| Customer Service | ||
| Health Care Quality | ||
| Rating of Health Plan | ||
| Care Coordination |
Member Complaints and Changes in Humana Gold Choice H8145-120 (PFFS) Plans Performance
| Total Rating | ||
|---|---|---|
| Members Leaving the Plan | ||
| Complaints about Health Plan | ||
| Health Plan Quality Improvement |
Health Plan Customer Service Rating for Humana Gold Choice H8145-120 (PFFS)
| Total Customer Service Rating | ||
|---|---|---|
| Timely Decisions About Appeals | ||
| Reviewing Appeals Decisions |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating | ||
|---|---|---|
| Breast Cancer Screening | ||
| Colorectal Cancel Screening | ||
| Cardiovascular Screening | ||
| Diabetes Care | ||
| Annual Flu Vaccine | ||
| Improving Physical | ||
| Improving Mental Health | ||
| Monitoring Physical Activity | ||
| Adult BMI Assessment |
Ratings For Managing Chronic And Long Term Care
| Total Rating | ||
|---|---|---|
| SNP Care Management | ||
| Medication Review | ||
| Functional Status Assessment | ||
| Pain Screening | ||
| Osteoporosis Management | ||
| Diabetes Care - Eye Exam | ||
| Diabetes Care - Kidney Disease | ||
| Diabetes Care - Blood Sugar | ||
| Diabetes Care - Cholesterol | ||
| Controlling Blood Pressure | ||
| Rheumatoid Arthritis | ||
| Improving Bladder Control | ||
| Reducing Risk of Falling | ||
| Plan - Cause Readmissions |
Ratings For Member Experience with the Drug Plan
| Total Rating | ||
|---|---|---|
| Rating of Drug Plan | ||
| Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
| Total Rating | ||
|---|---|---|
| MPF Price Accuracy | ||
| High Risk Medication | ||
| Diabetes Treatment | ||
| Drug Adherence for Diabetes Medications | ||
| Drug Adherence for Hypertension (RAS antagonists) | ||
| Drug Adherence for Cholesterol (Statins) |
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating | ||
|---|---|---|
| Complaints about the Drug Plan | ||
| Members Choosing to Leave the Plan | ||
| Drug Plan Quality Improvement |
Humana Gold Choice H8145-120 (PFFS) Drug Plan Customer Service ratings
| Total Rating | ||
|---|---|---|
| Appeals Auto Forward | ||
| Appeals Upheld |
Source: CMS.
Plans as of September 2, 2014.
Star Rating as of Oct 3, 2014.
For More Information on Ratings Please See the CMS Tech Notes Here.
Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit
Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.
