Humana Gold Choice H2944-197 (PFFS)


Medicare Plan Details

2021 Plan
Monthly Premium
(select county for price)

 

by Humana
Additional Coverage
Hearing
Overall Government Star Rating
 3.5
out of 5 stars

State: Kansas

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$19
$19
$0
$0
$6,700 In and Out-of-network
No
Yes
No
No

Medical Benefits

Doctor Services

In-network: $10 copay per visit
Out-of-network: No Data
In-network: $40 copay per visit
Out-of-network: No Data

Tests, labs, & imaging

In-network: $0-40 copay or 20% coinsurance
Out-of-network: No Data
In-network: $0-30 copay or 25% coinsurance
Out-of-network: $0 copay
In-network: $40-270 copay or 20-30% coinsurance
Out-of-network: No Data
In-network: $10-40 copay or 30% coinsurance
Out-of-network: No Data
$90 copay per visit (always covered)
$10-40 copay per visit (always covered)

Hospital Services

In-network: $360 per day for days 1 through 5
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
Out-of-network: Not Applicable
In-network: $40-360 copay or 20% coinsurance per visit
Out-of-network: No Data

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

In-network: $265 copay
Out-of-network: No Data

Therapy services

In-network: $35-40 copay
Out-of-network: No Data
In-network: $35-40 copay
Out-of-network: No Data

Mental health services

In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data

Opioid treatment services

Covered

Other services

In-network: 19% coinsurance per item
Out-of-network: 19% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: No Data
In-network: $0 copay or 10-20% coinsurance per item
Out-of-network: 20% coinsurance per item

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

In-network: 20% coinsurance
Out-of-network: No Data
In-network: 20% coinsurance
Out-of-network: No Data

Extra Benefits

Hearing

In-network: $40 copay
Out-of-network: No Data
Not covered
Not covered
Not covered
Not covered

Preventive Dental

Not covered
Not covered
Not covered
Not covered

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Other benefits

Not covered
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 3.5
 3
 3
 4
 4
 4

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