Physicians that accept Humana Gold Choice H8145-120 (PFFS) for Arkansas
Insurance Type | Medicare Advantage Plan (Part C) |
Insurance Provider | Humana |
Plan ID | H8145-120-0 |
Plan Year | 2019 |
CMS Rating | |
Plan Type | PFFS |
Annual Deductible | $0.00 |
What To Know About This Plan |
|
Plan Year | 2019 |
Monthly Health Plan Premium | $43.00 |
Monthly Drug Plan Premium | Not Applicable |
Health Plan Deductible | $150 In-network $150 Out-of-network |
Other health plan deductibles? | No |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) | $6,700 In and Out-of-network |
Optional Supplemental Benefits | Yes |
SERVICE | COST |
Inpatient hospital coverage | In-Network:$360 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond Out-of-Network:40% per stay |
Outpatient hospital coverage | In-Network:20% per visit Out-of-Network:40% per visit |
Doctor visits | Primary: In-Network:$20 per visit Out-of-Network:40% per visit Specialist: In-Network:$50 per visit Out-of-Network:40% per visit |
Preventive care | In-Network:$0 copay Out-of-Network:$0 or 40% |
Emergency care/Urgent care | Emergency:$90 per visit (always covered) Urgent care:$20-50 or 40% per visit (always covered) |
Diagnostic procedures/lab services/imaging | Diagnostic tests and procedures: In-Network:$0-50 or 20% Out-of-Network:40% Lab services: In-Network:$0-30 or 25% Out-of-Network:40% Diagnostic radiology services (e.g., MRI): In-Network:$50-360 or 20% Out-of-Network:40% Outpatient x-rays: In-Network:$20-50 or 20% Out-of-Network:40% |
Mental health services | Inpatient hospital - psychiatric: In-Network:$318 per day for days 1 through 5 $0 per day for days 6 through 90 Out-of-Network:40% per stay Outpatient group therapy visit with a psychiatrist: In-Network:$40 Out-of-Network:40% Outpatient individual therapy visit with a psychiatrist: In-Network:$40 Out-of-Network:40% Outpatient group therapy visit: In-Network:$40 Out-of-Network:40% Outpatient individual therapy visit: In-Network:$40 Out-of-Network:40% |
Skilled Nursing Facility | In-Network:$0 per day for days 1 through 20 $167.50 per day for days 21 through 100 Out-of-Network:40% per stay |
Rehabilitation services | Occupational therapy visit: In-Network:$35-40 Out-of-Network:40% Physical therapy and speech and language therapy visit: In-Network:$35-40 Out-of-Network:40% |
Ground ambulance | In-Network:$265 Out-of-Network:$265 |
Transportation | Not covered |
Foot care (podiatry services) | Foot exams and treatment: In-Network:$50 Out-of-Network:40% Routine foot care:Not covered |
Medical equipment/supplies | Durable medical equipment (e.g., wheelchairs, oxygen): In-Network:20% per item Out-of-Network:20% per item Prosthetics (e.g., braces, artificial limbs): In-Network:20% per item Out-of-Network:20-40% per item Diabetes supplies: In-Network:$0 or 10-20% per item Out-of-Network:20-40% per item |
Wellness programs (e.g., fitness, nursing hotline) | Covered |
Medicare Part B drugs | Chemotherapy: In-Network:20% Out-of-Network:20% Other Part B drugs: In-Network:20% Out-of-Network:20% |
Hearing | |
Hearing exam | In-Network: $50 Out-of-Network: 40% |
Fitting/evaluation | Not covered |
Hearing aids - inner ear | Not covered |
Hearing aids - outer ear | Not covered |
Hearing aids - over the ear | Not covered |
Preventive Dental | |
Oral exam | Not covered |
Cleaning | Not covered |
Fluoride treatment | Not covered |
Dental x-ray(s) | Not covered |
Comprehensive Dental | |
Non-routine services | Not covered |
Diagnostic services | Not covered |
Restorative services | Not covered |
Endodontics | Not covered |
Periodontics | Not covered |
Extractions | Not covered |
Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
Vision | |
Routine eye exam | In-Network: $0 copay Out-of-Network: $0 copay There may be limits on how much the plan will provide. |
Other | Not covered |
Contact lenses | Not covered |
Eyeglasses (frames and lenses) | Not covered |
Eyeglass frames | Not covered |
Eyeglass lenses | Not covered |
Upgrades | Not covered |
State | Arkansas |
County | Pulaski |
Breast cancer screening | |
Colorectal cancer screening | |
Annual flu vaccine | |
Improving or maintaining physical health | |
Improving or maintaining mental health | |
Monitoring physical ability | |
Adult BMI assessment |
Special needs plan care management | Not Rated |
Care for older adults – medication review | Not Rated |
Care for older adults – functional status assessment | Not Rated |
Care for older adults – Pain screening | Not Rated |
Osteoporosis management in women who had a fracture | |
Diabetes care – eye exam | |
Diabetes care – kidney disease monitoring | |
Diabetes care – blood sugar controlled | |
Controlling blood pressure | |
Rheumatoid arthritis management | |
Reducing the risk of falling | |
Plan all-cause readmissions |
Getting needed care | |
Getting appointments and care quickly | |
Customer service | |
Overall rating of health care quality | |
Overall rating of plan | |
Care Coordination |
Complaints about the health plan | |
Members choosing to leave the health plan | |
Beneficiary access and performance problems | |
Health plan quality improvement |
Plan makes timely decision about appeals | |
Reviewing appeals decisions | |
Call center – foreign language interpreter and TTY/TDD availability - Medical |
Call center – foreign language interpreter and TTY/TDD availability - Drugs | |
Appeals auto-forward | |
Appeals upheld |
Complaints about the drug plan | |
Members choosing to leave the drug plan | |
Beneficiary access and performance problems | |
Drug plan quality improvement |
Rating of drug plan | |
Getting needed prescription drugs |
MPF Price Accuracy | |
High risk medication | |
Part D medication adherence for diabetes | |
Part D medication adherence for hypertension | |
Part D medication adherence for cholesterol | |
Medication Therapy Management program completion rate |
Physicians that accept Humana Gold Choice H8145-120 (PFFS) for Arkansas
![]() |
| Select | ||||
![]() |
| Select | ||||
![]() |
| Select | ||||
![]() |
| Select | ||||
![]() |
| Select |
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.