Humana Gold Choice H8145-042 (PFFS)

3.5 out of 5 stars

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Monthly Premium

Humana Gold Choice H8145-042 (PFFS) is a PFFS plan offered by Humana Inc.

Plan ID: H8145-042

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as Humana Gold Choice H8145-042 (PFFS) - H8145-042 by Humana Inc. as well as other Medicare Advantage plans available in your area.

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Monthly Premium

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$-1
Out of Pocket Max	In-Network: $-1 Out-of-Network: 5900
Initial Coverage Limit	$0
Catastrophic Coverage Limit	$2100
Primary Care Doctor Visit	Out-of-Network: Doctor Office Visit Services: Copayment for Medicare Covered Primary Care Office Visit $0
Specialty Doctor Visit	In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $30
Inpatient Hospital Care	Out-of-Network: Acute Hospital Services: $345 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 Transportation	In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $335 Air Ambulance: Copayment for Air Ambulance Services $335

Health Care Services and Medical Supplies

Humana Gold Choice H8145-042 (PFFS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage	Cost
Chiropractic Services	In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 Out-of-Network: Chiropractic Services: Copayment for Medicare Covered Chiropractic Services $15
Diabetes Supplies, Training, Nutrition Therapy and Monitoring	In-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	In-Network: Outpatient Diag Procs/Tests/Lab Services: Copayment for Medicare-covered Diagnostic Procedures/Tests $0 to $120 Copayment for Medicare-covered Lab Services $0 to $50 $120 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$30 OP Diag Proc & Tests - SPC$40 OP Diag Proc & Tests - UCC$120 Sleep Study (Fac Based) - OPH$30 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0 to $335 Copayment for Medicare-covered Therapeutic Radiological Services $30 Coinsurance for Medicare-covered Therapeutic Radiological Services 20% Copayment for Medicare-covered X-Ray Services $0 to $130
Home Health Care	In-Network: Home Health Services: Copayment for Medicare-covered Home Health Services $0
Mental Health Inpatient Care	In-Network: Psychiatric Hospital Services: $345 per day for days 1 to 5 $0 per day for days 6 to 90
Mental Health Outpatient Care	In-Network: Outpatient Mental Health Services: Copayment for Medicare-covered Individual Sessions $35 Copayment for Medicare-covered Group Sessions $35
Outpatient Services / Surgery	In-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0 to $375 $0 Diag Colonoscopy - OPH$35 Mental Health - OPH$375 Surgery Svcs - OPH$30 Wound Care - OPH Outpatient Observation Services: Copayment for Medicare Covered Observation Services - Per stay $345 Ambulatory Surgical Center Services: Copayment for Ambulatory Surgical Center Services $0 to $300 $0 Diag Colonoscopy - ASC$300 Surgery Svcs - ASC
Outpatient Substance Abuse Care	Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $35 Copayment for Medicare Covered Group Sessions $35 In-Network: Outpatient Substance Abuse Services: Copayment for Medicare-covered Individual Sessions $35 Copayment for Medicare-covered Group Sessions $35
Over-the-counter (OTC) Items	Over-the-Counter: $150 quarterly allowance to buy approved over-the-counter health and wellness products available through our OTC Mail Order provider. Unused amount rolls over to the next quarter and expires at the end of the plan year.
Podiatry Services	In-Network: Podiatry Services: Copayment for Medicare-Covered Podiatry Services $30 Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $30
Skilled Nursing Facility Care	In-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 from in-network providers.

Coverage	Cost
Dental Care	Plan covers up to $2,500 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. Note: The allowance cannot be used on fluoride, cosmetic services and implants.

Coverage

Cost

Dental Care

Plan covers up to $2,500 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.
Note: The allowance cannot be used on fluoride, cosmetic services and implants.

Vision Benefits

The following vision services are covered from in-network providers.

Coverage	Cost
Vision Benefits	Out-of-Network: Eye Exams Services: Copayment for Medicare Covered Eye Exams $0 to $30 Copayment for Medicare Covered Eyewear $0 $0 Diab Eye Exam - All POTs$30 Vision Svcs (MC) - SPC

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage	Cost
Hearing Benefits	In-Network: Hearing Exams: Copayment for Medicare Covered Benefits $30 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 $99 to $399 Maximum 2 Hearing Aids every year

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage	Cost
Preventive Services and Health/Wellness Education Programs	Out-of-Network: Medicare-covered Preventive Services: Copayment for Medicare Covered Medicare-covered Preventive Services $0

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