Humana Gold Plus H4461-037 (HMO)
Tennessee Medicare Advantage Plan (2023 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
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Plan Overview
Humana Gold Plus H4461-037 (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Tennessee and offered by the health insurance company Humana. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Humana Gold Plus H4461-037 (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $5,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Humana Gold Plus H4461-037 (HMO) are defined below.
Additional Benefits and Coverage
Humana Gold Plus H4461-037 (HMO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Humana Gold Plus H4461-037 (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Humana Gold Plus H4461-037 (HMO) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of Humana Gold Plus H4461-037 (HMO) to Other Plans in Tennessee
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2023, Humana Gold Plus H4461-037 (HMO) received an overall government quality rating of 5.0 stars out of 5 stars.
Humana Gold Plus H4461-037 (HMO) performed better than Tennessee’s State average overall quality score of 4.3 stars.
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Humana Gold Plus H4461-037 (HMO) received 5 stars for its health plan quality score which is better than the Tennessee State average health plan quality score of 4.3 stars.
Humana Gold Plus H4461-037 (HMO) received 4 stars for its drug plan quality score which is better than the Tennessee State average drug plan quality score of 3.6 stars.
Plan Benefits and Coverage Details
Medical Benefits
Doctor Services
Tests, labs, & imaging
Hospital Services
$0 per day for days 7 through 90
$0 per day for days 91 and beyond
Skilled nursing facility
$196 per day for days 21 through 100
Preventive services
Ambulance
Therapy services
Mental health services
Opioid treatment services
Other services
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $0.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | $5.00 copay | ||
| Preferred Brand | $47.00 copay | ||
| Non-Preferred Drug | $97.00 copay | ||
| Specialty Tier | 33% |
Part B Drugs
Extra Benefits
Hearing
Preventive Dental
Comprehensive dental
Vision
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