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.

336 Comments

  1. I am already in a Humana Gold Plus HMO plan. Will I automatically be re-enrolled for the 2022 Plan period. If so what date would that be and will I receive my new card in the mail? With so many persons calling about medicare want to make sure I continue with Humana plan.

    Reply
    • I am already a Humana member doI need to sign up?

      Reply
  2. I was told that dental work is covered up to $2000 per year for crowns etc. The chart does not say. Also, what does “Medicare covered dental expenses” entail?

    Reply
    • does humana cover dentured realignment

      Reply
    • I had an oral exam and xrays and recieved a bill for $173, why? I visited Total Smiles of Roxboro, NC. I never had to pay at Person Family Medical and Dental of Roxboro, why? My Member ID is H41906790 DOB 11/21/1953

      Reply
    • I would like to know if crowns are covered also

      Reply
      • Want to know what I have available to me this year on the gold plan. And next year

        Reply
  3. I have Humana Gold Plus. Are OTC suppliments covered?

    Reply
  4. Will hearing devices be covered or not.

    Reply
  5. Would like to know more about Humana Gold Plus HMO plan.

    Reply
  6. Do you offer the flexcard i hear about?

    Reply
  7. I have Humana Gold plus (HMO)
    Will I be automaticly get the 2022 plan ?

    Reply
  8. I’m enrolled in a plan Humana Gold Plus(HMO D-SNP)how do I find doctors in that network?

    Reply
  9. I ALSO WOULD LIKE TO KNOW WHAT DOES MEDICARE COVERED DENTAL EXPENSES ENTAIL?

    Reply
  10. I already have Humana Plus, Can I get new dentures ?

    Reply
  11. My dental said only cleaning & X-Ray. You cal that dental ins.

    Reply
  12. Does The vaccination for pneumococcal , Shingles, and Tetanus for my 73 of age covered by my Humana Gold Plus (HMO-POS) , I got a mail from Humana stated that it is recommended by the CDC but not stated the coverage.

    Reply
  13. Which plan pays better for patients on chemo?

    Reply
  14. When I will go back home (U.S.) my old Humana Health Card is still good
    without reenrolling now because I am now out of the country

    Reply
  15. Hi i am going for cataract surgery how much will it cost me?

    Reply

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