Take a look at the Humana Gold Plus HMO plan for Seniors

Take a look at the Humana Gold Plus HMO plan for Seniors

Humana Gold Plus® is a Medicare Advantage Health Maintenance Organization (HMO) plan with a wide range of coverage for seniors. Humana has contracted with Medicare to provide you with services that are not covered by your Medicare Part A and Part B benefits under original Medicare. Most Medicare Advantage Humana Gold Plus HMO Plans offer prescription drug coverage. With Gold Plus HMO Plans your out-of-pocket costs are reduced and more predictable than with the majority of other plans. You may enroll in Gold Plus HMO plan only during specific times of the year. You can compare this to Humana’s Gold Choice PFFs, Humana’s Part D Drug Plans, HumanaChoice PPO and Humana Enhanced PDP. Below is an example of one of the many plans offered by Humana.

Summary

Plan Type Humana Gold Plus H1951-013 (HMO)
Office Visit for Primary Doctor $10 copay for each primary care doctor visit for Medicare-covered benefits.
Office Visit for Specialist $10 to $25 copay for each specialist visit for Medicare-covered benefits.
Doctor Choice Plan Doctor Only
Annual Deductible None
Out-of-Pocket Maximum $4,900
Prescription Drug Coverage Yes
Physical Exams $0 copay for all preventive services covered under Original Medicare at zero cost sharing.

Hospital Services Coverage

Emergency Room $65 copay for Medicare-covered emergency room visits. $25,000 plan coverage limit for emergency services outside the U.S. every year.
Ambulance Services $200 copay for Florida Medicare-covered ambulance benefits.
Outpatient Lab/X-Ray $0 to $25 copay for Medicare-covered lab services. $0 to $50 copay for Medicare-covered diagnostic procedures and tests. $10 to $50 copay for Medicare-covered X-rays.
Outpatient Surgery $250 copay for each Medicare-covered ambulatory surgical center visit. $0 to $250 copay [or 20% of the cost] for each Medicare-covered outpatient hospital facility visit.
Urgent Care $10 to $25 copay for Medicare-covered urgently needed care visits.
Hospitalization No limit to the number of days covered by the plan each hospital stay. For Medicare-covered hospital stays: Days 1 – 7: $175 copay per day; Days 8 – 90: $0 copay per day; $0 copay for each additional hospital day.
Outpatient Rehabilitation Services $10 copay for Medicare-covered Occupational Therapy visits. $10 copay for Medicare-covered Physical and/or Speech and Language Therapy visits.
Skilled Nursing Facility Plan covers up to 100 days each benefit period; No prior hospital stay is required. For SNF stays: Days 1 – 5: $0 copay per day; Days 6 – 20: $50 copay per day; Days 21 – 100: $100 copay per day.
Home Health Care $0 copay for each Medicare-covered home health visit.
Hospice You must get care from a Medicare-certified hospice.

Retail Pharmacy for Prescription Drugs

Prescription Drug Deductible None
Preferred Generic You pay the following until total yearly drug costs reach $2,930: – $6 copay for a one-month (30-day) supply of drugs in this tier; – $18 copay for a three-month (90-day) supply of drugs in this tier.
Non-Preferred Generic You pay the following until total yearly drug costs reach $2,930: – $10 copay for a one-month (30-day) supply of drugs in this tier; – $30 copay for a three-month (90-day) supply of drugs in this tier.
Preferred Brand You pay the following until total yearly drug costs reach $2,930: – $45 copay for a one-month (30-day) supply of drugs in this tier; – $135 copay for a three-month (90-day) supply of drugs in this tier.
Non-Preferred Brand You pay the following until total yearly drug costs reach $2,930: – $95 copay for a one-month (30-day) supply of drugs in this tier; – $285 copay for a three-month (90-day) supply of drugs in this tier.
Specialty 33% coinsurance for a one-month (30-day) supply of drugs in this tier.

Mail Order Pharmacy for Prescription Drugs

Preferred Generic You pay the following until total yearly drug costs reach $2,930: – $0 copay for a one-month (30-day) supply of drugs in this tier from a preferred mail order pharmacy; – $0 copay for a three-month (90-day) supply of drugs in this tier from a preferred mail order pharmacy.
Non-Preferred Generic You pay the following until total yearly drug costs reach $2,930: – $0 copay for a one-month (30-day) supply of drugs in this tier from a preferred mail order pharmacy; – $0 copay for a three-month (90-day) supply of drugs in this tier from a preferred mail order pharmacy.
Preferred Brand You pay the following until total yearly drug costs reach $2,930: – $45 copay for a one-month (30-day) supply of drugs in this tier from a preferred mail order pharmacy; – $125 copay for a three-month (90-day) supply of drugs in this tier from a preferred mail order pharmacy.
Non-Preferred Brand You pay the following until total yearly drug costs reach $2,930: – $95 copay for a one-month (30-day) supply of drugs in this tier from a preferred mail order pharmacy; – $275 copay for a three-month (90-day) supply of drugs in this tier from a preferred mail order pharmacy.
Specialty 33% coinsurance for a one-month (30-day) supply of drugs in this tier from a preferred mail order pharmacy.

Additional Coverage

Dental Services $0 copay for the following preventive dental benefits: – $0 copay for up to 1 oral exam(s) every year; – $0 copay for up to 1 cleaning(s) every year; – $0 copay for up to 1 dental x-ray(s) every year. $25 copay for Medicare-covered dental benefits.
Hearing Services In general, routine hearing exams and hearing aids not covered. – $25 copay for Medicare-covered diagnostic hearing exams.
Vision Services $0 copay for one pair of eyeglasses or contact lenses after cataract surgery. – $0 to $25 copay for exams to diagnose and treat diseases and conditions of the eye. – $0 copay for up to 1 supplemental routine eye exam(s) every year.
Chiropractic Coverage $20 copay for each Medicare-covered visit. Medicare-covered chiropractic visits are for manual manipulation of the spine to correct subluxation (a displacement or misalignment of a joint or body part) if you get it from a chiropractor or other qualified providers.
Outpatient Mental Health Coverage $25 copay for each Medicare-covered individual therapy visit, $25 copay for each Medicare-covered group therapy visit, $25 copay for each Medicare-covered individual therapy visit with a psychiatrist, $25 copay for each Medicare-covered group therapy visit with a psychiatrist, $25 copay for the cost for Medicare-covered partial hospitalization program services.

351 Comments

  1. Have to have a total knee replacement do my humma gold cover that

    Reply
  2. what is my cost for lantus and novolog pen incilin–i was quoted

    cost would be 35.00 per box throughout 2021.if not i am changing plans to other

    Reply
  3. Why is the Humana gold plus dental coverage worthless. What seniors really need is our eyes,teeth, hearing. Only to have very sorry coverage.

    Reply
    • Rhonda, you can get extra dental coverage through multiple different providers. I would first recommend asking your dentist whom they recommend and going from there. I have found that multiple dentists do offer their own coverage now that may help cover dental expenses better than what a private company can offer.

      Hope this helps,

      Nick

      Reply
  4. Is someone eligible for this plan if they already have Tri-Care?

    Reply
  5. I need to cancel my Humana Gold plan, I have been to several places online and can’t find one where I can cancel.

    Reply
  6. I want to have additional dental coverage for me and my wife.

    Reply
  7. need to know if oxygen at home is approved for copd patient on Hunmana Gold hmo plan

    Reply
  8. How much will Humana gold plus cover for a Da Texan brain SPECT at Swedish hospital Seattle. They say it will cost 2400 dollars before insurance.

    Reply
  9. Will Humana gold plus cover or cover some of the cost for a Da T scan brain scan at Swedish hospital in Seattle.they say it will cost $2400 before insurance.

    Reply
    • Do my Humana gold plus plan cover Seattle cancer care alliance?!

      Reply
  10. How much will Humana gold plus cover for a D Tscan at Swedish hospital Seattle. They say it will cost $2400 before insurance.

    Reply
  11. My Mother needs home health care or a Rehab facility. She is unable to walk, can’t dress herself, someone has to dress her and change her. Light appetite and this is a result of Covid, a collapsed lung and phenomena. We need help right away. We live in Odessa Florida and need to find somewhere she could go close to home.

    Reply
  12. what is the co pay for a PET scan at a cancer center

    Reply
  13. I’m covered with Medicare Part B with extra help and Medicaid. Feeling not been treat fairly by current provider, I intend to switch to Humana. As hearing impaired and a computer novice, please let me know by return email
    whether you offer a plan that waives copay, drug list and member of your
    pharmacy network in Irmo SC 29063 and possible help to enroll. On hearing from you I can determine the feasibility. Thanks

    Reply
  14. I’m gonna be 65 years old next year I just wanna know when should I apply for this

    Reply
  15. Does Humana gold plus cover cataract surgery?

    Reply

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