Humana Gold Plus HMO Medicare Advantage 2025
Are you comparing Medicare Advantage plan options for 2025?
With 2025 right around the corner, it’s important to be prepared. We can easily help you find the right Medicare Advantage plan to fit your needs, and many people will likely be looking at the Humana Gold Plus HMO Medicare Advantage Plan due to its extensive coverage and competitive costs.
Whether you’re evaluating the plan’s benefits, deciphering out-of-pocket obligations, or seeking details on prescription drug coverage, our analysis strips away the complexity to focus on what you need to know without the fluff.
Key Takeaways
- The Humana Gold Plus HMO Medicare Advantage Plan offers an extensive network covering 94% of U.S. counties and includes additional benefits like dental, vision, and unique options for veterans.
- Cost considerations for the Humana Gold Plus Plan encompass the premium, deductibles, copays, and coinsurance, with an average annual out-of-pocket expense estimated at $3,600, excluding the Medicare Part B premium.
- Prescription drug coverage under Humana Gold Plus is structured with a tier system that affects the cost of medicines, while the plan offers comprehensive support services and access to wellness programs, including SilverSneakers.
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Understanding Humana Gold Plus HMO Medicare Advantage Plan
The Humana Gold Plus HMO Medicare Advantage Plan, a part of Humana Medicare, is a versatile healthcare plan that covers over 5.5 million Medicare beneficiaries.
With an average star rating of 4.34 for 2024, Humana’s Medicare Advantage HMO plans, including the popular Humana Medicare Advantage option, have received rave reviews from experts and beneficiaries alike.
When considering the Humana Medicare Advantage cost, it’s important to weigh the benefits and coverage provided by this comprehensive Humana Medicare Advantage Plan, as well as other Humana Medicare Advantage plans available.
What Sets Humana Gold Plus Apart?
Humana Gold Plus stands out with its comprehensive coverage that goes beyond the basics. Routine dental, vision, and hearing benefits, as well as prescription drug coverage, are all part of the deal.
Moreover, this plan has a unique feature for veterans. It provides Honor plans, specifically crafted to complement VA coverage, addressing the distinctive healthcare needs of U.S. military veterans.
Network and Coverage Specifics
The Humana Gold Plus HMO Medicare Advantage Plan, which is a type of Medicare Advantage plan, covers 94% of U.S. counties, offering an extensive network for its beneficiaries.
However, network restrictions may impact both the cost and accessibility of care for those seeking Medicare Advantage PPO plans and other Medicare plans.
You can verify if your doctor is within the network by examining the plan’s network details on the official Humana website.
Plan Costs and Financial Considerations
Financial transparency is key when choosing a healthcare plan. For Humana Gold Plus, the comprehensive expenses include:
- Premium
- Deductibles
- Copays
- Coinsurance
There are no undisclosed costs. The estimated average annual out-of-pocket expense is $3,600.
Understanding Your Out-of-Pocket Responsibilities
Your out-of-pocket expenses with Humana Gold Plus include:
- Copayments for primary care visits: $0
- Copayments for specialist visits: $20
- Coinsurance: individuals are required to pay a percentage of the cost of medical services or supplies.
Deductibles are predetermined amounts that members are required to pay out-of-pocket before the plan starts covering medical expenses. The plan’s out-of-pocket maximum is $3,000.
The Impact of Medicare Part B Premium
While the plan may have a $0 premium, members are still required to pay the Medicare Part B premium.
The current rate for the Medicare Part B premium is $164.90 per month for 2023, and the standard monthly premium rate for 2024 is established at $174.70.
The premium is subject to change throughout the year, impacting the overall cost of the Humana Gold Plus Plan.
Prescription Drug Coverage Under Humana Gold Plus
Prescription drug coverage is an essential component of the Humana Gold Plus Plan. The coverage varies depending on the specific plan and location. The plan offers a range of tiers for prescription coverage, classifying medications according to cost and type.
You can determine if your medication is covered by consulting the Humana Drug List, also known as the formulary.
Managing Medication Costs
Managing prescription medication costs is made easier with Humana Gold Plus. The plan controls prescription medication costs through prescription discounts and a tier system.
The pricing of prescription drugs is influenced by factors such as the tier of the medication and out-of-pocket costs including deductibles, copays, and coinsurance.
The usual expenses associated with prescription medications may differ based on the individual plan and the specific medications prescribed.
Eligibility and Enrollment
To qualify for the Humana Gold Plus HMO Medicare Advantage Plan, individuals must be entitled to and enrolled in Medicare, either being 65 years or older or under 65 with end-stage renal disease (ESRD). Additionally, they must also reside within the plan’s service area, which includes states like MD, ME, MI, MN.
Enrollment Periods and Deadlines
Enrollment in Humana Gold Plus is limited to specific periods. The Annual Election Period spans from October 15th to December 7th each year. Specific life events, such as changes in residence or eligibility for the state Medicaid program, can trigger a Special Enrollment Period.
Member Services and Support
Humana Gold Plus, a Humana plan, provides a robust member support system and access to resources, including tools, forms, and assistance with using the plan.
Members can access healthcare services by locating doctors, retail clinics, urgent care centers, and hospitals within the plan’s network.
For service support, individuals can contact the clinical intake team at 1-800-523-0023 to initiate medical service preauthorization requests and notifications.
Accessing Healthcare Services
Members can access healthcare services through the plan’s network of providers and utilize online tools and resources for support. The Humana provider search tool on their website can be used to find in-network healthcare providers.
Members can also schedule appointments using online tools provided by Humana Gold Plus, such as the MyHumana app or by logging into their MyHumana account on the Humana website.
Additionally, Humana Gold Plus members can access telehealth or virtual healthcare services.
Comparing Humana Gold Plus to Other Medicare Advantage Plans
Factors like coverage, additional benefits, cost, network, and CMS Star Ratings should be considered while comparing Humana Gold Plus with other Medicare Advantage plans.
Humana Gold Plus distinguishes itself from other plans like Aetna Medicare Advantage plans by having a larger share of the Medicare Advantage market and offering more extensive plan availability.
User reviews of Humana Gold Plus suggest that it is highly esteemed and well-received, recognized for its exceptional prescription coverage and no-cost monthly plans.
Plan Comparison Checklist
The evaluation of benefits and services offered is crucial when assessing the differences in coverage between various Medicare Advantage plans.
Humana Gold Plus provides a comprehensive package encompassing Medicare benefits, prescription drug plans, as well as routine dental, vision, and hearing coverage. The pricing of Humana Gold Plus may differ depending on location and specific plan details.
Comparing premiums, deductibles, copayments, and coinsurance with those of other Medicare Advantage plans could provide valuable insight into the overall costs.
Additional Benefits and Wellness Programs
Humana Gold Plus incorporates wellness programs like Go365, SilverSneakers®, and Sharecare, promoting the health and wellness of its members.
As a participant, you are afforded the opportunity to utilize the SilverSneakers Fitness program at no extra charge, granting you access to a network of gyms and fitness centers across the country.
Humana Gold Plus, a provider of Medicaid services, also offers transportation benefits including ambulance services to hospitals or skilled nursing facilities, as well as complimentary transportation for prescription medications or medical supplies.
Special Features for Veterans
Humana Gold Plus offers unique benefits for veterans, such as the Honor plan, which supplements VA coverage.
The Humana Gold Plus Honor plan is a Medicare Advantage plan specifically tailored for veterans, providing supplementary health care options and benefits, including dental, vision, and hearing care, to complement VA health coverage.
Legal and Compliance Aspects
The Humana Health Group, a reputable health insurance company, has been assigned an A (Excellent) rating by AM Best, indicating an excellent ability to meet ongoing insurance obligations.
For detailed information on compliance requirements, consider referring to the official Humana website or contacting Humana directly.
Summary
Humana Gold Plus HMO Medicare Advantage Plan offers comprehensive coverage, including prescription drug, vision, dental, and hearing benefits. Its extensive network, cost transparency, and robust member support system make it a popular choice among Medicare beneficiaries.
It also stands out with its unique features for veterans, offering the Honor plan to supplement their VA coverage.
However, as with any healthcare plan, it is crucial to weigh the costs, benefits, network, and additional features before deciding.
Consult the Humana website or contact Humana directly for comprehensive information on compliance requirements and to ascertain if your medication is covered under the plan.
Frequently Asked Questions
→ What are the disadvantages of Humana Gold Plus?
The disadvantages of Humana Gold Plus Medicare include network limitations, prior authorization requirements, plan restrictions, and potential plan changes.
It’s important to weigh these factors against your coverage needs, cost considerations, preferred providers, and flexibility preferences when deciding if it’s worth it for you.
→ What type of insurance is Humana Gold Plus?
Humana Gold Plus is a Medicare Advantage HMO plan.
→ What are the 2025 changes to Humana Gold Plus?
In 2025, the changes to Humana Gold Plus will simplify drug coverage by offering the same cost-share at all in-network retail pharmacies. This will make it easier for you to fill your prescriptions.
→ What are the key features of the Humana Gold Plus HMO Medicare Advantage Plan?
The key features of the Humana Gold Plus HMO Medicare Advantage Plan include coverage for prescription drugs, vision, dental, and hearing benefits, with a specific focus on delivering healthcare services for veterans.
→ How does the Humana Gold Plus plan effectively control the costs associated with prescription medications?
The Humana Gold Plus plan effectively controls prescription medication costs through prescription discounts and a tier system. By leveraging these strategies, members can save on their medication expenses.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.