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Humana Gold Choice H8145-126 (PFFS) - H8145-126-000

3.5 out of 5 stars* for plan year 2026

$0.00

Monthly Premium

Humana Gold Choice H8145-126 (PFFS) is a PFFS Medicare Advantage (Medicare Part C) plan offered by Humana Inc.

Plan ID: H8145-126-000

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

$0.00

Monthly Premium

Arkansas, Illinois, Kansas, Missouri, Oklahoma, and Texas 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 Arkansas, Illinois, Kansas, Missouri, Oklahoma, and Texas 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

1-855-861-8771
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TTY 711, 24/7

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible-$1.00
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 $40
Inpatient hospital careIn-Network:

Acute Hospital Services:
$360 per day for days 1 to 5
$0 per day for days 6 to 90
Urgent care
Urgent Care:
Copayment for Urgent Care $50

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $90
Emergency room visit
Emergency Care:
Copayment for Emergency Care $90

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $90
Copayment for Worldwide Emergency Transportation $90
Ambulance transportation
Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $250
Coinsurance for Medicare Covered Ambulance Services - Air 20%

Health Care Services and Medical Supplies

Humana Gold Choice H8145-126 (PFFS) covers a range of additional benefits. Learn more about Humana Gold Choice H8145-126 (PFFS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic servicesIn-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% to 20%
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $10
Durable medical equipment (DME)In-Network:

Durable Medical Equipment:
Copayment for Medicare-covered Durable Medical Equipment $0
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
$20 to $50
Coinsurance for Medicare Covered Diagnostic Procedures/Tests
30%
Copayment for Medicare Covered Lab Services
$20 to $50
Coinsurance for Medicare Covered Lab Services
30%
Copayment for Medicare Covered Diagnostic Radiological Services $0
Coinsurance for Medicare Covered Diagnostic Radiological Services 30%
Coinsurance for Medicare Covered Therapeutic Radiological Services 30%
Copayment for Medicare Covered Outpatient X-Ray Services $20 to $50
Coinsurance for Medicare Covered Outpatient X-Ray Services 30%
$50 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$40 OP Diag Proc & Tests - SPC$50 OP Diag Proc & Tests - UCC$50 Sleep Study (Fac Based) - OPH$50 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home
Home health careIn-Network:

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

Psychiatric Hospital Services:
$360 per day for days 1 to 4
$0 per day for days 5 to 90
Mental health outpatient care
Out-of-Network:

Mental Health Services:
Copayment for Medicare Covered Individual Sessions $50
Copayment for Medicare Covered Group Sessions $50
Outpatient services/surgery
Out-of-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $50
Coinsurance for Medicare Covered Outpatient Hospital Services 30%
Copayment for Medicare Covered Ambulatory Surgical Center Services $0
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 30%
$0 Diag Colonoscopy - OPH$35 Mental Health - OPH$360 Surgery Svcs - OPH$45 Wound Care - OPH
Outpatient substance abuse care
Out-of-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $50
Coinsurance for Medicare Covered Individual Sessions 30%
Copayment for Medicare Covered Group Sessions $50
Coinsurance for Medicare Covered Group Sessions 30%
$35 OP Substance Abuse Care - OPH$30 OP Substance Abuse Care - SPC
Over-the-counter itemsOver-the-Counter: $90 quarterly allowance on a prepaid spending card to buy approved over-the-counter health and wellness products at participating retail locations or through the plan's approved OTC mail order vendor.
Unused amount rolls over to the next quarter and expires at the end of the plan year.
Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $40
Skilled Nursing Facility (SNF) care
Out-of-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$150 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 care$0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years.
$0 copayment for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years.
$0 copayment for bridge recementation, bridges-pontic, complete dentures, crown recementation, panoramic film or diagnostic x-rays, partial dentures up to 1 every 5 years.
$0 copayment for bridges-crown up to 2 every 5 years.
$0 copayment for crown, other restorative services - core buildup and prefabricated post and core, root canal, root canal retreatment up to 1 per tooth per lifetime.
$0 copayment for bitewing x-rays, intraoral x-rays up to 1 set(s) per year.
$0 copayment for adjustments to dentures, denture rebase, denture reline, denture repair, emergency diagnostic exam, tissue conditioning up to 1 per year.
$0 copayment for emergency treatment for pain, oral surgery, periodic oral exam, prophylaxis (cleaning) up to 2 per year.
$0 copayment for periodontal maintenance up to 4 per year.
$0 copayment for necessary anesthesia with covered service up to as needed with covered codes per year.
$0 copayment for amalgam and/or composite filling, simple or surgical extraction up to unlimited per year.
$3,500 combined maximum benefit coverage amount per year for all diagnostic/preventive and comprehensive benefits.

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 $50
Coinsurance for Medicare Covered Eye Exams 50%
Coinsurance for Medicare Covered Eyewear 30%
$0 Diab Eye Exam - All POTs$40 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 careIn-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $40
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

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
Coinsurance for Medicare Covered Medicare-covered Preventive Services 50%

When reviewing Arkansas, Illinois, Kansas, Missouri, Oklahoma, and Texas 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 Arkansas, Illinois, Kansas, Missouri, Oklahoma, and Texas that offer similar benefits at similar or lower prices than the plan above. Call 1-855-861-8771 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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