Humana Gold Choice H8145-163 (PFFS) H8145-163-0 Plan Details
Humana Gold Choice H8145-163 (PFFS) H8145-163-0 Plan Details
Choosing the right Medicare Advantage plan is crucial for your healthcare needs in 2026. With Humana Gold Choice H8145-163 (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 130 members enrolled in this plan.
Humana Gold Choice H8145-163 Overview
| Plan ID H8145-163-0 Overview | |
|---|---|
| Health Plan ID: | H8145-163-0 |
| Medicare Advantage Plan Type: | PFFS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $1500.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | See List |
| Insured By: | Humana |
Plan Availability
Humana Gold Choice H8145-163 (H8145-163-0) is available in the following locations (click to open):
Explore the Benefits of Humana Gold Choice H8145-163
With a monthly premium of $0.00, this Private Fee-for-Service Medicare Advantage plan gives you broad access to care and the flexibility to choose your providers. It covers all the essential benefits of Medicare Part A and Part B and allows you to see any Medicare-approved provider who agrees to the plan’s terms — no referrals or networks required.
Primary care visits have a $0 copay | Out-of-network: $0 copay, specialist visits come with a $0 copay | Out-of-network: $0 copay, lab services cost {lab_services_cost}, urgent care services carry a $0 copay, and ambulance transportation is $335 copay | Out-of-network: $335 copay. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $1500.00. Once that limit is met, your covered services are paid at 100% — making this a solid choice for anyone who values provider freedom and predictable expenses.
You’ll find this plan listed by CMS as H8145-163-0. A breakdown of cost sharing follows. Still have questions? Check the FAQ section for more details.
| We're Here to Help You Enroll |
|---|
Cost-Sharing Overview
Humana Gold Choice H8145-163 includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H8145-163-0.
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: $0 copay | Out-of-network: $0 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-$35 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: | $150 copay |
| Wordwide emergency care: | $150 copay |
| Urgent care: | $0 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $0 per stay | Out-of-network: | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $20 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | $20 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: $35 copay | Out-of-network: $40 copay |
| Outpatient group therapy: | In-network: $35 copay | Out-of-network: $40 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $0 per stay | Out-of-network: | $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: $20-$40 copay | Out-of-network: $20-$40 copay |
| Occupational therapy: | In-network: $20-$40 copay | Out-of-network: $20-$40 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%-20% coinsurance | Out-of-network: 20% 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-$780 copay | Out-of-network: $0-$780 copay |
| Lab services: | In-network: $0-$20 copay | Out-of-network: $0-$20 copay |
| Outpatient x-rays: | In-network: $0-$100 copay | Out-of-network: $0-$100 copay |
| Diagnostic tests and procedures: | In-network: $0-$105 copay | Out-of-network: $0-$105 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: | Not covered |
| Endodontics: | Not covered |
| Restorative services: | Not covered |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | Not covered |
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: | In-network: $0 copay | Out-of-network: $0 copay |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Humana Gold Choice H8145-163 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Overview
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.
Who Can Enroll in Humana Gold Choice H8145-163?
You are eligible to enroll in Humana Gold Choice H8145-163 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 H8145-163 and take advantage of its full range of benefits.
When Can I Enroll in Humana Gold Choice H8145-163?
Knowing when you can enroll in Humana Gold Choice H8145-163 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 Enroll in Humana Gold Choice H8145-163
Joining Humana Gold Choice H8145-163 is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Humana Gold Choice H8145-163.
- Direct Enrollment: You can also choose to enroll directly with Humana Gold Choice H8145-163. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H8145-163-0:
What’s the monthly premium for Humana Gold Choice H8145-163 (PFFS)?
The 2026 premium is $0.00 each month, and you must continue to pay your Part B premium.
What is the annual out-of-pocket maximum on this plan?
Your costs top out at $1500.00 (for in-network services) in 2026; after that the plan pays 100% of covered services.
What’s the CMS star score for Humana Gold Choice H8145-163?
The latest CMS score is ★3.5 out of 5 stars; anything 4 or higher earns quality bonuses.
How many people are enrolled in this plan?
CMS reports 130 members in the latest file.
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
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — 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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