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  1. TN
  2. Humana
  3. Plan

Humana Gold Plus H4461-037 (HMO)

Medicare Plan Details (2022 Plan)

Monthly Premium

 

by Humana
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 5.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

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

 

Plan Details

$0
$0
$0
$0
$5,900 In-network
No
Yes
Yes
Yes
http://www.humana.com/medicare
http://www.humana.com/medicare

Medical Benefits

Doctor Services

$0 copay
$25 copay per visit

Tests, labs, & imaging

$0-100 copay
$0-25 copay
$25-250 copay
$0-100 copay
$90 copay per visit (always covered)
$0-25 copay per visit (always covered)

Hospital Services

$275 per day for days 1 through 6
$0 per day for days 7 through 90
$0 per day for days 91 and beyond
$25-255 copay per visit

Skilled nursing facility

$0 per day for days 1 through 20
$188 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$290 copay

Therapy services

$20 copay
$20 copay

Mental health services

$25 copay
$25 copay
$25 copay
$25 copay

Opioid treatment services

Covered

Other services

20% coinsurance per item
20% coinsurance per item
$0 copay or 10-20% coinsurance per item

Prescription Drug Benefits

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

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$10.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$3.95 copay or 5% (whichever costs more)

Brand-name drugs :
$9.85 copay or 5% (whichever costs more)

Generic$20.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug$100.00 copay
Specialty Tier33%

Part B Drugs

20% coinsurance
20% coinsurance

Extra Benefits

Hearing

$25 copay
$0 copay
$299-599 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

0% coinsurance
Not covered
0% coinsurance
Not covered
0% coinsurance
0% coinsurance
0% coinsurance

Vision

$0 copay
$0 copay
$0 copay
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage

Health Plan Star Ratings

(government star ratings are out of 5 stars)
 5
 4
 4
 5
 5
 5

Prescription Drug Plan Star Ratings

(government star ratings are out of 5 stars)
 5
 5
 5
 5
 4

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 

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