Humana Gold Plus H0028-029 (HMO) 2024 Benefit Details for Plan H0028-029-0 by Humana
Humana Gold Plus H0028-029 is a 2024 HMO Medicare Advantage plan {with_without_pdp} Part D.
This Humana option offers the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may also include additional, valuable benefits not covered by Part A or Part B.
Plan Basics | |
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Plan ID: | H0028 029 0 |
Plan Type: | Local HMO |
Plan Year: | 2024 |
Premium: | $0.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | $3,400/yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Enhanced, $0.00 deductible |
Rx Gap Coverage: | Yes |
Supplemental Benefits: | Dental, Vision, Hearing |
Availability: | See List |
Insured By: | Humana |
Summary of Benefits |
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Health Plan Cost Sharing
This Humana Medicare Advantage plan has cost-sharing. These are costs you must pay out-of-pocket when you use approved health services.
NOTE: Most preventive services are covered 100% by the plan as a Part B benefit.
The following table summarizes the most common out-of-pocket costs you will incur if you join this plan unless you go out-of-network:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | $0 Copay |
Specialist: | $20 Copay Authorization Required, Referral Required |
Wellness programs (e.g., fitness, nursing hotline): | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $20 Copay Authorization Required, Referral Required |
Routine foot care: | Not Covered |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $20 Copay Authorization Required, Referral Required |
Routine chiropractic care: | Not Covered |
Emergency Care / Urgent Care | |
Emergency room care: | $135 Copay |
Urgent care: | $65 Copay |
Ground ambulance: | $300 Copay |
Inpatient hospital coverage: | $50.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital coverage: | $30 Copay Authorization Required, Referral Required |
Skilled Nursing Facility: | $20.00 per day for days 1 through 20 $203.00 per day for days 21 through 40 $203.00 per day for days 41 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $20 Copay |
Outpatient group therapy visit with a psychiatrist: | $20 Copay |
Inpatient hospital - psychiatric: | $50.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy visit: | $20 Copay |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $40 Copay Authorization Required, Referral Required |
Occupational therapy visit: | $40 Copay Authorization Required, Referral Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | 20% Coinsurance Authorization Required |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | $300 Copay Authorization Required, Referral Required |
Lab services: | $0 Copay Authorization Required, Referral Required |
Outpatient x-rays: | $125 Copay Authorization Required, Referral Required |
Diagnostic tests and procedures: | $65 Copay Authorization Required, Referral Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Humana Gold Plus H0028-029 Summary of Benefits information.
Supplemental Benefits
The following is a summary of the supplemental benefits Humana includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | Maximum dental benefit: | $2,500.00 Every year |
Oral exam (In-Network) | Covered |
Fluoride treatment (In-Network) | Covered |
Dental x-ray(s) (In-Network) | Covered |
Cleaning (In-Network) | Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Covered |
Non-routine services (In-Network) | Covered |
Diagnostic services (In-Network) | Covered |
Extractions (In-Network) | Covered |
Endodontics (In-Network) | Covered |
Restorative services (In-Network) | Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | $0 Copay Authorization Required, Referral Required, Limitations Apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay Authorization Required, Referral Required |
Vision | Maximum vision benefit: | $200.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay Authorization Required, Referral Required |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Prescription Drug Plan Costs & Benefits
Humana Gold Plus H0028-029 includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. LIS, also known as Extra Help, is a Social Security program that helps people with limited income and resources lower or cut Part D costs.
The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $0.00 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $0.00 |
Part D Premium with Full LIS Assistance: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before Humana begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Humana Gold Plus H0028-029 has out-of-pocket costs that you must pay when you pick up your prescriptions.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | N/A | $0.00 copay |
2 (Generic) | N/A | $0.00 copay |
3 (Preferred Brand) | N/A | $45.00 copay |
4 (Non-Preferred Drug) | N/A | $99.00 copay |
5 (Specialty Tier) | N/A | 33% |
CMS Rating Marks for 2024
Each year Medicare rates health plans (Part C) and drug plans (Part D) in several major categories based on a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join this Humana plan.
CMS Measure | Star Rating |
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2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
This Medicare Advantage HMO plan is way better than average. Here's how we can make this claim. Staying healthy is the best way to save money on health care, and Humana Gold Plus H0028-029 does a good job keeping its members in top health through preventive care, including screenings, tests, and vaccines. This plan is good at managing its member's chronic (long-term) health conditions.
The member experience with this Humana plan is average. Complaints and changes in performance with this plan are average. The plan shines at customer service with an overall excellent mark on this important metric.
If you're looking for more value, this plan offers dental, vision, and hearing benefits (limitations may apply) that are not included with Original Medicare.
With no additional monthly premium, this plan can save you money if you're healthy. Humana Gold Plus H0028-029 has a moderate maximum out-of-pocket (MOOP) limit of $3,400 per year, which does not include prescriptions. With this MOOP, you're in the same range as Original Medicare for a 5-day stay in the hospital. With no annual deductible, members of this health plan have first dollar coverage, which is comforting on a fixed budget.
Plan Availability
Humana Gold Plus H0028-029 (H0028-029-0) is available in the following locations (click to open):
Additional Medicare Advantage Plan Options
The Medicare Advantage program offers a myriad of options, including these plans:
- H0028-048-2: Humana Gold Plus H0028-048 (HMO)
- H0028-025-1: Humana Gold Plus H0028-025 (HMO)
- H0028-053-4: Humana Gold Plus H0028-053 (HMO)
- H0028-021-0: Humana Gold Plus H0028-021 (HMO)
- H0028-017-0: Humana Gold Plus H0028-017 (HMO)
Contact Humana
Plan Website: | http://www.humana.com/medicare |
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Formulary Information: | https://www.humana.com/pharmacy/ |
Pharmacy Information: | Humana Pharmacy Page |
Prospective Members: | (800)833-2364 |
TTY Users: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Humana, http://www.humana.com/medicare, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Your Medicare coverage choices", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed February 19, 2024
- Medicare.gov, "Your Medicare Coverage", Last Accessed April 11, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
About This H0028-029-0 Plan Detail Page
The data on this Humana Gold Plus H0028-029 plan detail page is derived from the 2024 Landscape Source Files, Plan Benefit Package, and Medicare Part C and Part D Performance Data published by CMS.
The author interprets these files, and their associated data dictionary, with great care, making every attempt to communicate the data submitted by Humana to CMS as clearly and accurately as possible. Given the complexity of the data, the author recommends that all potential enrollees request an official Summary of Benefits from Humana, at (800)833-2364, prior to enrollment.