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Humana Gold Choice H8145-006 (PFFS) - H8145-006-000

3.5 out of 5 stars* for plan year 2026

$37.00

Monthly Premium

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

Plan ID: H8145-006-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$37.00

Monthly Premium

Illinois, Iowa, Kansas, Michigan, Missouri, Montana, Oklahoma, and Wisconsin Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover.

Learn more about Illinois, Iowa, Kansas, Michigan, Missouri, Montana, Oklahoma, and Wisconsin Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price. 

Enrollment may be limited to certain times of the year. See why you may be able to enroll today.

Compare plans today.

Speak with a licensed insurance agent

1-888-876-5731
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Basic Costs and Coverage

CoverageDetails
Monthly plan premium$37.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$615.00
Out-of-pocket maximum-$1.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$2,100.00
Primary care doctor visitIn-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0
Specialty doctor visitIn-Network:

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

Acute Hospital Services:
$360 per day for days 1 to 7
$0 per day for days 8 to 90
Urgent care
Urgent Care:
Copayment for Urgent Care $40

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $115
Emergency room visit
Emergency Care:
Copayment for Emergency Care $115

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $115
Copayment for Worldwide Emergency Transportation $115
Ambulance transportationIn-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $335

Air Ambulance:
Coinsurance for Air Ambulance Services 20%

Health Care Services and Medical Supplies

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

CoverageDetails
Chiropractic services
Out-of-Network:

Chiropractic Services:
Copayment for Medicare Covered Chiropractic Services $15
Diabetes supplies, training, nutrition therapy and monitoringIn-Network:

Diabetic Supplies and Services:
Copayment for Medicare-covered Diabetic Supplies $0
Coinsurance for Medicare-covered Diabetic Supplies 10%
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $10
Durable medical equipment (DME)
Out-of-Network:

Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 20%
$0 Continuous Glucose Monitor - DME Prov$0 Continuous Glucose Monitor - Pharmacy20% DME - DME Prov20% DME - Pharmacy
Diagnostic tests, lab and radiology services, and X-rays
Out-of-Network:

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 $335
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$40 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
Out-of-Network:

Home Health Services:
Copayment for Medicare Covered Home Health $0
Mental health inpatient careIn-Network:

Psychiatric Hospital Services:
$297 per day for days 1 to 7
$0 per day for days 8 to 90
Mental health outpatient care
Out-of-Network:

Mental Health Services:
Copayment for Medicare Covered Individual Sessions $30
Copayment for Medicare Covered Group Sessions $30
Outpatient services/surgeryIn-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $300
$0 Diag Colonoscopy - OPH$35 Mental Health - OPH$300 Surgery Svcs - OPH$55 Wound Care - OPH

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $360

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0 to $200
$0 Diag Colonoscopy - ASC$200 Surgery Svcs - ASC
Outpatient substance abuse care
Out-of-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $30 to $35
Copayment for Medicare Covered Group Sessions $30 to $35
$35 OP Substance Abuse Care - OPH$30 OP Substance Abuse Care - SPC
Podiatry services
Out-of-Network:

Podiatry Services:
Copayment for Medicare Covered Podiatry Services $55
Skilled Nursing Facility (SNF) careIn-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$218 per day for days 21 to 100

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental carePlan 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.

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

CoverageDetails
Vision care
Out-of-Network:

Eye Exams Services:
Copayment for Medicare Covered Eye Exams $0 to $55
Copayment for Medicare Covered Eyewear $20
$0 Diab Eye Exam - All POTs$55 Vision Svcs (MC) - SPC

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing care
Out-of-Network:

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

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Preventive services and health/wellness education programs
Out-of-Network:

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) offers prescription drug coverage, with an annual drug deductible of $615.00 (excludes Tiers 1 and 2)

Coverage & Cost
Coverage
Cost
Annual drug deductible$615.00 (excludes Tiers 1 and 2)
Tier 1
  • Standard retail $0.00
  • Preferred mail order $0.00
  • Standard mail order $10.00
Tier 2
  • Standard retail $5.00
  • Preferred mail order $5.00
  • Standard mail order $20.00
Annual drug deductible$615.00 (excludes Tiers 1 and 2)
Tier 1
  • Standard retail N/A
  • Preferred mail order N/A
  • Standard mail order N/A
Tier 2
  • Standard retail N/A
  • Preferred mail order N/A
  • Standard mail order N/A
Annual drug deductible$615.00 (excludes Tiers 1 and 2)
Tier 1
  • Standard retail $0.00
  • Preferred mail order $0.00
  • Standard mail order $30.00
Tier 2
  • Standard retail $15.00
  • Preferred mail order $0.00
  • Standard mail order $60.00

When reviewing Illinois, Iowa, Kansas, Michigan, Missouri, Montana, Oklahoma, and Wisconsin Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Illinois, Iowa, Kansas, Michigan, Missouri, Montana, Oklahoma, and Wisconsin that offer similar benefits at similar or lower prices than the plan above. Call 1-888-876-5731 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

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We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Healthspring, Wellcare, or Kaiser Permanente.

Enrollment may be limited to certain times of the year. See why you may be able to enroll today.

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