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Written by David Bynon [3], Medicare Analyst since 2012.  Last updated April 27, 2025

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Medicare Advantage
 » 
Puerto Rico
 » 
Quebradillas Municipio
 » 
Humana Gold Plus H4007-024

Humana Gold Plus H4007-024 (HMO) – H4007-024-0

⭐  Rating : CMS uses a 5-star system to rate Medicare Advantage plans based on quality, member experience, and service. ☆☆☆☆☆ (4 out of 5 stars from CMS)*
Humana logo, a registered trademark of Humana
Premium: Monthly premium you pay in addition to your Medicare Part B premium. 0.00/mo + Part B premium
Deductible: The amount you must pay before your health plan coverage begins. Does not include the prescription plan deductible, if any. $0.00
MOOP: Maximum Out-of-Pocket cost for in-network services per year. $5,000.00 /yr
Giveback: Monthly credit applied toward your Part B premium, if applicable. $0.00/mo
Prescriptions: Summary of drug plan coverage and deductible. Enhanced, $0.00 deductible
Availability: County or region where this plan is offered. See List
Supplemental: Common additional benefits offered, including dental, vision, and hearing. Vision, Hearing
Insured by: The organization marketing the plan. Click for contact details. Humana

This page provides coverage, cost, and availability details for Humana’s H4007-024-0 Medicare Advantage plan for 2025.

Is Humana Gold Plus H4007-024 (HMO) not the plan you want? See all Medicare Advantage Plans in Quebradillas Municipio, Puerto Rico.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. The Humana logo is a registered trademark. [2] Its use by MedicareWire is strictly for editorial purposes. This is not a solicitation of insurance.

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Health Plan Costs

💰 Monthly Premium, Deductible, Max Out-of-Pocket & Giveback

Monthly Premium: The total monthly premium is $0.00, including drug coverage. You must also pay your standard Medicare Part B premium.

Health Plan Deductible: Some health plans have a deductible (amount you pay before cost-sharing begins). This plan's deductible is $0.00.

Maximum Out-of-Pocket: All Medicare Advantage plans have an annual maximum out-of-pocket (MOOP) limit. This is the most you will pay for standard health services in a year before that plan begins paying all costs. This plan's MOOP is $5,000.00 for in-network services, excluding the cost of your Part D medications.

Part B Giveback: This plan offers a Part B premium giveback of $0.00.

Health Plan Out-of-Pocket Costs

🩺 Doctor’s Office Visits
  • Primary: $0 Copay
  • Specialist: $0 Copay
    Referral Required
  • NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
🏥 Emergency, Urgent, and Inpatient Hospital Coverage
  • Emergency room care: $75 Copay
  • Urgent care: $10 Copay
  • Ground ambulance: $75 Copay
  • Inpatient hospital care: $75.00 per stay
  • Skilled Nursing Facility: $0.00 per stay
🦶 Foot Care
  • Foot Exams and Treatments (Medicare-covered): $0 Copay
  • Routine Foot Care: Not Covered
💆 Chiropractic Care
  • Medicare-covered chiropractic: $0 Copay
    Referral Required
  • Routine chiropractic: Not Covered
🧠 Mental Health Services
  • Outpatient individual therapy: $0 Copay
  • Outpatient group therapy: $0 Copay
  • Inpatient psychiatric hospital care: $75.00 per stay
🏋️ Rehabilitation Services
  • Physical therapy and speech and language therapy: $6 Copay
    Prior Authorization Required
  • Occupational therapy: $6 Copay
    Prior Authorization Required
🧰 Medical Equipment and Supplies
  • Diabetes supplies: $0 Copay
  • Durable medical equipment: $0 Copay
    Prior Authorization Required
  • Prosthetics: Not Covered
🔬 Diagnostics, Lab Services, and Imaging
  • Diagnostic radiology services: $75 Copay
    Prior Authorization Required
  • Lab services: $0 Copay
    Prior Authorization Required, Referral Required
  • Outpatient x-rays: $10 Copay
    Prior Authorization Required
  • Diagnostic tests and procedures: $20 Copay
    Prior Authorization Required, Referral Required
💉 Medicare Part B Drugs
  • Chemotherapy: 20% Coinsurance
  • Other Part B drugs (Medicare-covered): 20% Coinsurance

Supplemental Benefits

🦷 Dental Services
  • Medicare Covered Preventive Dental: $0 Copay
    Prior Authorization Required
  • Oral exam: 0% Coinsurance
  • Dental x-rays: 0% Coinsurance
  • Cleaning: 0% Coinsurance
  • Periodontics: Not Covered
  • Endodontics: Not Covered
  • Restorative Services: Not Covered
👂 Hearing Aids and Services
  • Fitting/evaluation: Covered
    Limits may apply
  • Hearing aids: Not Covered
  • Hearing exam: Covered
    Limits may apply
👓 Vision Services
  • Medicare-covered eye exam: $0 Copay
  • Routine eye exam: $0 Copay
    1 Every year
  • Eyewear benefits: Eyeglasses: No
    Contact Lenses: No
    Eyeglass Lenses: No
    Eyeglass Frames: No
    Eyewear Upgrades: No
  • Maximum eyewear benefit:
    $2.00
    Every three years
Do you have questions about costs in this plan? Call 1-855-728-0510 (TTY 711) to speak with a licensed insurance agent and learn more about this plan and other plans on this site (Mon-Fri 5am-6pm, Sat 6am-5pm PT).

Prescription Drug Costs & Benefits

Humana Gold Plus H4007-024 includes enhanced benefit Medicare Part D. Enhanced benefits offer greater coverage than basic, typically providing lower cost-sharing, broader drug coverage, and additional benefits, such as covering drugs not included in the standard formulary. These plans usually have higher premiums due to the extra coverage and flexibility they provide, but they cover a larger percentage of overall drug costs.

As of 2023, approximately 75% of people on Medicare are enrolled in enhanced plans.

Prescription Drug Costs & Benefits

📦 This plan’s prescription drug deductible is $0.00.

You’ll need to pay this amount before Humana begins helping with drug costs.

📊 See what you’ll pay for covered prescriptions by tier and pharmacy type.
Part D Drug Costs by Tier
Drug Tier Retail Pharmacy Mail Order
Preferred Generic$0.00$0.00
Generic$0.00$0.00
Preferred Brand$10.00$11.00
Non-Preferred Drug33.00%33.00%
Specialty Tier33.00%33.00%
Select Care Drugs$0.00$0.00
* Not all tiers apply to the deductible. See the formulary for full details.

Drug tiers group medications by type and cost. Tier 1 has the lowest-cost generics, and Tier 5 includes specialty drugs.

View the plan’s complete formulary drug list (opens in a new browser tab).

💡 Learn how Extra Help could lower your drug costs.

If you qualify for the Social Security Extra Help program, your Part D premium may be reduced.

Extra Help Premium Breakdown
Low Income Premium Subsidy: ${part_d_lips_amount}
Amount Paid by CMS: $0.00
Your Adjusted Premium: $0.00

Learn more at the Social Security Extra Help program .

CMS 5-Star Rating Marks

Each year the Centers for Medicare & Medicaid Services (CMS) rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories using a 5-star rating system. Here are the most recent CMS ratings for Humana Gold Plus H4007-024.

CMS Ratings Breakdown – 2025

Health Plan Ratings

  • ☆☆☆☆☆
    Staying Healthy Includes screenings, tests, and vaccines to keep you well.
  • ☆☆☆☆☆
    Managing Chronic Conditions How well the plan helps members manage long-term health issues.
  • ☆☆☆☆☆
    Member Experience with Health Plan Reflects what members say about their health plan experience.
  • ☆☆☆☆☆
    Complaints and Changes in Plan Performance Tracks complaints and year-over-year performance changes.
  • ☆☆☆☆☆
    Health Plan Customer Service How well the plan handles appeals and customer help.

Drug Plan Ratings

  • ☆☆☆☆☆
    Drug Plan Customer Service Service quality specific to the Part D drug plan.
  • ☆☆☆☆☆
    Complaints and Changes in the Drug Plan How well the drug plan resolves issues and maintains quality.
  • ☆☆☆☆☆
    Member Experience with Drug Plan Satisfaction with drug coverage and related services.
  • ☆☆☆☆☆
    Drug Safety & Pricing Accuracy How accurate the plan is with pricing and safe medication practices.

* CMS uses a 5-star rating system to evaluate Medicare Advantage and Part D plans each year. Learn more at Medicare.gov.

Plan Availability

Humana Gold Plus H4007-024 (H4007-024-0) is available in the following locations (click to open):

Adjuntas
Aguada
Aguadilla
Aguas Buenas
Aibonito
Au00f1asco
Arecibo
Arroyo
Barceloneta
Barranquitas
Bayamu00f3n
Cabo Rojo
Caguas
Camuy
Canu00f3vanas
Carolina
Catau00f1o
Cayey
Ceiba
Ciales
Cidra
Coamo
Comeru00edo
Corozal
Culebra
Dorado
Fajardo
Florida
Guu00e1nica
Guayama
Guayanilla
Guaynabo
Gurabo
Hatillo
Hormigueros
Humacao
Isabela
Jayuya
Juana Du00edaz
Juncos
Lajas
Lares
Las Maru00edas
Las Piedras
Lou00edza
Luquillo
Manatu00ed
Maricao
Maunabo
Mayagu00fcez
Moca
Morovis
Naguabo
Naranjito
Orocovis
Patillas
Peu00f1uelas
Ponce
Quebradillas
Rincu00f3n
Ru00edo Grande
Sabana Grande
Salinas
San Germu00e1n
San Juan
San Lorenzo
San Sebastiu00e1n
Santa Isabel
Toa Alta
Toa Baja
Trujillo Alto
Utuado
Vega Alta
Vega Baja
Vieques
Villalba
Yabucoa
Yauco

Need Help Enrolling?

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Or enroll online through our trusted and secure platform:

🚀 Enroll Online Now

Clicking this button will open MedicareEnrollment.com (powered by HealthCompare Insurance Services) and the official Humana plan page.

📄 View Humana Contact Information
Helpful Links and Contact Information for Humana
Website: Humana Plan Page (opens in new tab)
Providers: Humana Providers Page (opens in new tab)
Formulary: Humana Formulary Page (opens in new tab)
Pharmacy: Humana Pharmacy Page (opens in new tab)
New Member Health Plan Help: (800)681-3625
New Member Health Plan TTY: 711
New Member Part D Help: (800)681-3625
New Member Part D TTY Users: 711

🔍 Why This Information Matters

Many Medicare websites only show you their own phone numbers and redirect you to their sales team. We believe you deserve full access to your plan resources — including direct links to the official Humana site, provider directories, and support contacts.

That’s why we include this information here, clearly and transparently — so you can research and enroll with confidence.

🛡️ Official Medicare Enrollment Resources

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 Part C program on www.medicare.gov or call 1-800-MEDICARE.

Frequently Asked Questions

📘 What does Medicare plan code H4007 024 mean?

Humana Gold Plus H4007-024 is a Medicare Advantage plan by Humana. The code H4007 is the CMS contract ID, whereas 024 is its plan ID.

  • Plan Name: Humana Gold Plus H4007-024
  • Plan Type: HMO
  • Premium: $0.00/mo + your monthly Part B premium
  • Out-of-Pocket Max: $5,000.00 (in-network)
  • Drug Coverage: Includes Medicare Part D prescription drug coverage with tiered cost sharing.
  • CMS Star Rating: 4 out of 5
  • Contract Year: 2025

This information is based on official CMS data and is provided for educational purposes. Always review your plan’s official documents or contact the provider directly before making enrollment decisions.

📋 What type of plan is H4007 024?

This plan is a HMO — specifically, it's an HMO plan with a Medicare Advantage contract that's offered by Humana. It comes with defined provider network rules you should be aware of.

  • Plan Marketing Name: Humana Gold Plus H4007-024
  • Network Type: Health Maintenance Organization with in-network care coordination
  • Referral Requirement: Referrals are typically required for specialty care. See the benefit cost tables above for specific services.
  • Prescription Coverage: Includes Medicare Part D prescription drug coverage with tiered cost sharing.

Plan types like HMOs and PPOs determine whether you can go out-of-network or need referrals to see specialists.

📦 What benefits are included in H4007 024?

This plan covers all Medicare Part A and Part B services. Depending on the plan, it may also include valuable extras like dental, vision, and hearing benefits.

  • Medical Services: Hospital, doctor visits, preventive care
  • Prescription Drugs: Enhanced, $0.00 deductible
  • Dental: No — this plan does not include dental benefits.
  • Vision: Yes — vision benefits are included. Review the vision section above for copay and limit details.
  • Hearing: Yes — hearing benefits are included. See the coverage details above to learn what services are covered.

Benefit availability may vary by location and plan version. Confirm specific details in your plan's Evidence of Coverage (EOC).

📌 Additional Plan Options

Additional Plan Options

The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:

  1. Humana Gold Plus H4007-021 (HMO)
  2. Humana Gold Plus H4007-025 (HMO)
  3. Humana Gold Plus H4007-029 (HMO)
  4. Humana Gold Plus H4007-028 (HMO-POS)
  5. Humana Gold Plus H4007-024 (HMO)
  6. Humana Gold Plus H4007-012 (HMO)

If you are enrolled in a Part C plan with prescription drug coverage, you cannot be enrolled in a stand-alone Medicare Part D plan, regardless of your chosen insurance company.

You cannot be enrolled in a Part C health plan and simultaneously hold Medicare Supplement Insurance (Medigap). Medicare Supplement plans are only compatible with Medicare Parts A and B.

📚 Citations & Research

Citations & References

  • Humana, http://www.humana.com/medicare, Last Accessed March 1, 2025
  • Medicare.gov, "Medicare Advantage Plans cover all Medicare services", Last Accessed February 20, 2024
  • Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed February 19, 2024
  • Medicare.gov, "Medicare & You Handbook", Last Accessed March 19, 2025
  • Medicare.gov, "Is Your Test, Item, or Service Covered?", Last Accessed March 19, 2025
  • CMS.gov, Landscape Source Files, Last Accessed March 15, 2025
  • CMS.gov, Medicare Part C & D Performance, Last Accessed March 15, 2025
  • CMS.gov, Plan Benefits Package, Last Accessed March 15, 2025

Research Note: This content is based on independent analysis of CMS data by David Bynon, Medicare analyst and founder of MedicareWire.

For details on how this plan was analyzed and constructed using CMS data, see our Medicare Plan Research Methodology.

Disclaimer: MedicareWire does not endorse or rank Medicare plans. Plan information is provided for educational and research purposes only and may not reflect the most current data available from CMS or the plan provider.

📋 Carrier Plans Available Through HealthCompare

Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

Primary Sidebar

On This Page

  • Introduction
  • Health Plan Costs
  • Prescription Costs
  • Plan Rating Marks
  • Get Help
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Many of the plans featured on MedicareWire are offered through our trusted partner, HealthCompare Insurance Services, Inc., a licensed sales agency. HealthCompare may compensate us if you enroll in a plan through their services. Online enrollment services are provided by MedicareEnrollment.com, a HealthCompare affiliate.

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[3]About the Author

David Bynon is a Medicare analyst, published author, and U.S. Navy veteran with over 40 years of experience in cryptology, cybersecurity, and healthcare systems. Since founding MedicareWire in 2012, he has provided unbiased, data-driven Medicare plan research to assist seniors in making informed decisions.

Previously, David served as Vice President of Global Systems at Sony Pictures Entertainment and Director of Systems and Networks at HealthNet, focusing on secure HMO and Medicare infrastructures. His military career includes serving as Command Chief at TACRON-11, earning multiple Navy Commendation Medals and other commendations.

Connect with David on LinkedIn or view his Amazon Author Profile. His latest book, Why Medicare Advantage Plans Are Bad, is available on Amazon.

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