2017 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | Humana Gold Choice H8145-120 (PFFS) | ||||
Location: | Kingfisher, Oklahoma Click to see other locations | ||||
Plan ID: | H8145 - 120 - 0 Click to see other plans | ||||
Member Services: | 1-800-457-4708 TTY users 711 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the Humana Gold Choice H8145-120 (PFFS) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $34.00 (see Plan Premium Details below) | ||||
Annual Rx Deductible: | no drug coverage | ||||
Health Plan Type: | PFFS * | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $0 | ||||
Number of Members enrolled in this plan in Oklahoma: | 403 members | ||||
Number of Members enrolled in this plan in (H8145 - 120): | 3,325 members | ||||
Plan’s Summary Star Rating: | 3.5 out of 5 Stars. | ||||
• Customer Service Rating: | 2 out of 5 Stars. | ||||
• Member Experience Rating: | 4 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. | ||||
— Plan Premium Details — | |||||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | 100% Subsidy | 75% Subsidy | 50% Subsidy | 25% Subsidy | |
Monthly Part D Premium with LIS: | $0.00 | $0.00 | $0.00 | $0.00 | |
— Plan Health Benefits — | |||||
** General Plan Information ** | |||||
Choice of Doctors?: Plan Doctors for Most Services | |||||
** Cost ** | |||||
Monthly Health Plan Premium: $34.00 | |||||
Monthly Drug Plan Premium: Not Applicable | |||||
Health Plan Deductible:
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Other Health Plan Deductibles?: No | |||||
Maximum Out-of-Pocket Enrollee Responsibility (does not include prescription drugs) : $6,700 In and Out-of-network | |||||
** Extra Benefits ** | |||||
Prescription Drugs Covered?: No | |||||
Optional Supplemental Benefits?: Yes | |||||
** Outpatient Care and Services ** | |||||
Ambulance:
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Doctor's office visits:
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Durable medical equipment (wheelchairs, oxygen, etc.):
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Emergency care: $75 per visit (always covered) | |||||
Home health care:
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Mental health care:
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Outpatient hospital:
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Renal dialysis:
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** Inpatient Care ** | |||||
Inpatient hospital care:
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Optional Supplemental Benefits?: Yes | |||||
Skilled Nursing Facility (SNF):
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Prescription Drugs Covered?: No | |||||
** Additional Benefits ** | |||||
Optional Supplemental Benefits?: Yes |