Humana Gold Choice H8145-006 (PFFS) 2026 Plan Details for Saint Louis County, Missouri Residents
Humana Gold Choice H8145-006 (PFFS) 2026 Plan Details for Saint Louis County, Missouri Residents
Choosing the right Medicare Advantage plan in Saint Louis County is crucial for your healthcare needs in 2026. With Humana Gold Choice H8145-006 (PFFS) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data, there are approximately 6,547 members enrolled in this plan, 51 in Saint Louis County.
Humana Gold Choice H8145-006 Overview
| Plan ID H8145-006-0 Overview | |
|---|---|
| Health Plan ID: | H8145-006-0 |
| Medicare Advantage Plan Type: | PFFS |
| Plan Year: | 2026 |
| Monthly Premium: | $37.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6800.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Saint Louis County, MO |
| Insured By: | Humana |
Why Consider Humana Gold Choice H8145-006?
This Medicare Advantage Prescription Drug (MAPD) Private Fee-for-Service (PFFS) plan combines broad coverage with the freedom to choose your providers. With a monthly premium of $37.00, it includes all standard benefits under Medicare Part A and Part B, plus built-in drug coverage for your ongoing prescriptions. The annual Part D deductible is $615.00. You can visit any Medicare-approved provider who accepts the plan’s payment terms — no referrals or networks required.
Primary care visits have a $0 copay | Out-of-network: $0 copay, specialist visits come with a $55 copay | Out-of-network: $55 copay, urgent care services carry a $40 copay, and ambulance transportation is $335 copay | Out-of-network: $335 copay. These costs apply toward the plan’s maximum out-of-pocket (MOOP) limit of $6800.00. After reaching that limit, your covered services are fully paid through year-end.
This plan is registered with CMS under ID H8145-006-0, making it a top choice for people who want all-in-one coverage without giving up provider flexibility. A detailed breakdown of cost sharing appears below. Still have questions? Check the FAQ section to learn more.
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Out-of-Pocket Expenses
Humana Gold Choice H8145-006 has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H8145-006-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $0 copay |
| Specialist: | In-network: $55 copay | Out-of-network: $55 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$55 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | Not covered |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $115 copay |
| Wordwide emergency care: | $115 copay |
| Urgent care: | $40 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $360 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay | Out-of-network: | $360 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | $0 per day for days 1-20 | $218 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $335 copay | Out-of-network: $335 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $30 copay | Out-of-network: $30 copay |
| Outpatient group therapy: | In-network: $30 copay | Out-of-network: $30 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $360 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay | Out-of-network: | $360 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $35 copay | Out-of-network: $35 copay |
| Occupational therapy: | In-network: $35 copay | Out-of-network: $35 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay, 10% coinsurance | Out-of-network: 10% coinsurance |
| Durable medical equipment: | In-network: $0 copay, 20% coinsurance | Out-of-network: 20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$335 copay, 20% coinsurance | Out-of-network: $0-$335 copay, 20% coinsurance |
| Lab services: | In-network: $0-$55 copay | Out-of-network: $0-$55 copay |
| Outpatient x-rays: | In-network: $0-$150 copay | Out-of-network: $0-$150 copay |
| Diagnostic tests and procedures: | In-network: $0-$95 copay | Out-of-network: $0-$95 copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay |
| Periodontics: | In-network: $0 copay | Out-of-network: $0 copay |
| Endodontics: | In-network: $0 copay | Out-of-network: $0 copay |
| Restorative services: | In-network: $0 copay, 30%-40% coinsurance | Out-of-network: $0 copay, 30%-40% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: $0 copay |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay |
| Prescription hearing aids: | In-network: $699-$999 copay | Out-of-network: $699-$999 copay |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: $0 copay |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Humana Gold Choice H8145-006 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Humana Gold Choice H8145-006 includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $10.80 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $10.80 |
| Low-Income Premium Subsidy: | $43.03 |
| Low-Income Premium Subsidy Paid by CMS: | $10.80 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Humana starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Humana Gold Choice H8145-006 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $5.00 copay | Coming soon |
| Preferred Brand | $47.00 copay | Coming soon |
| Non-Preferred Drug | 34% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| CMS Measure | Star Rating |
|---|---|
| 2026 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 |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Humana Gold Choice H8145-006?
You are eligible to enroll in Humana Gold Choice H8145-006 if you meet the following conditions:
- You qualify for Medicare Part A and Part B.
- You live in the plan’s service area.
If these criteria describe your situation, you’re eligible to sign up for Humana Gold Choice H8145-006 and take advantage of its full range of benefits.
When Can I Enroll in Humana Gold Choice H8145-006?
Knowing when you can enroll in Humana Gold Choice H8145-006 is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare if you are currently enrolled in a Medicare Advantage plan.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) for guidance from a licensed insurance agent.
How to Sign Up for Humana Gold Choice H8145-006
Getting started with Humana Gold Choice H8145-006 is simple. Here are your options:
- Online Enrollment: Easily enroll online using a secure form. Visit the MedicareEnrollment.com enrollment page and follow the steps to complete your enrollment.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will guide you through the process and answer any questions.
- Through Medicare.gov: Enroll through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the instructions to join a Medicare Advantage plan.
- Directly with the Plan: You can also enroll directly with Humana Gold Choice H8145-006. The plan's contact information is available below in the "Contact" section.
Be sure to enroll during the appropriate period to ensure your coverage begins without delay.
Here are some of the most frequently asked questions people have about plan ID H8145-006-0:
Is there a premium for this plan in 2026?
The 2026 premium is $37.00 each month, and you must continue to pay your Part B premium.
How high can my costs go in a worst-case year?
Your costs top out at $6800.00 (for in-network services) in 2026; after that the plan pays 100% of covered services.
Is there a Part D deductible with this plan?
The 2026 drug deductible is $615.00.
What’s the CMS star score for Humana Gold Choice H8145-006?
For 2026, plan H8145-006-0 has a ★3.5 rating. The best rating is 5 stars.
How many people are enrolled in this plan?
Enrollment stands at roughly 6,547 members.
Contact Humana
| Contact Type | Details |
|---|---|
| Website: | Humana Plan Page |
| New Members: | 1-888-873-0686 |
| Existing Members: | 1-800-457-4708 |
| Plan Address: | 101 E Main Street | Louisville, KY 40202 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Humana, http://www.humana.com/medicare — Last accessed October 13, 2025
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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