2018 Humana Gold Plus H6622-007 (HMO) H6622-7-0 in MT from Humana | HealthPocket

Humana Gold Plus H6622-007 (HMO)

Medicare Advantage Plan for Montana

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderHumana
Plan IDH6622-7-0
CMS Rating1
Plan TypeHMO
Annual Deductible$335.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage
  • was the 2nd best selling plan in Big Horn in 2018

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$4,900 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$16.70
Monthly Health Plan Premium
$8.30

Benefits

Service
Cost
Inpatient hospital coverage
$295 for days 1 through 5
$0 for days 6 through 90
$0 for days 91 and beyond
Outpatient hospital coverage
$450 per visit
Doctor visits
Primary:
$10 per visit
Specialist:
$45 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$80 per visit (always covered)
Urgent care:
$10-45 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
$0-100
Lab services:
$0-10
Diagnostic radiology services (e.g., MRI):
$35-450
Outpatient x-rays:
$10-100
Mental health services
$260 for days 1 through 5
$0 for days 6 through 90
Outpatient group therapy visit with a psychiatrist:
$40
Outpatient individual therapy visit with a psychiatrist:
$40
Outpatient group therapy visit:
$40
Outpatient individual therapy visit:
$40
Skilled Nursing Facility
$0 for days 1 through 20
$167.50 for days 21 through 100
Rehabilitation services
Occupational therapy visit:
$40
Physical therapy and speech and language therapy visit:
$40
Ambulance
$265-500
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
$45
Routine foot care:
Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
$0 or 10-20% per item
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for Humana Gold Plus H6622-007 (HMO)

StateMontana
CountyYellowstone

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$4 copay$10 copay$4 copay
Tier 2: Non-Preferred Generic$15 copay$20 copay$15 copay
Tier 3: Preferred Brand Name$47 copay$47 copay$47 copay
Tier 4: Non-Preferred Brand Name50% coinsurance50% coinsurance50% coinsurance
Tier 5: Specialty Tier26% coinsurance26% coinsurance26% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$12 copay$30 copay$0 copay
Tier 2: Non-Preferred Generic$45 copay$60 copay$0 copay
Tier 3: Preferred Brand Name$141 copay$141 copay$131 copay
Tier 4: Non-Preferred Brand Name50% coinsurance50% coinsurance50% coinsurance
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

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

Managing Chronic Conditions

Special needs plan care management
Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
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

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

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

Physician Finder

Physicians that accept Humana Gold Plus H6622-007 (HMO) for Montana

/
Michels, Frank
2019 Broadwater Ave
Billings, MT 59102
Petersen, Susan
2019 Broadwater Ave
Billings, MT 59102
Cobb, Patrick
1315 Golden Valley Cir
Billings, MT 59102
Bullman, Jon
2019 Broadwater Ave
Billings, MT 59102
Grosso, Steven
2510 17th Street West
Billings, MT 59102
Stevens, Nathan
1747 Poly Drive
Billings, MT 59102
Gurevitch, Earl
1766 Majestic Ln
Billings, MT 59102
Monday, Michael
1775 Spring Creek Dr
Billings, MT 59102
Steiner, Shannon
50 27th St W
Billings, MT 59102
Saberhagen, Eric
2675 Central Ave
Billings, MT 59102
Seas, Erica
2019 Broadwater Ave
Billings, MT 59102
Rondon, Oswald
2475 Village Ln Ste 202
Billings, MT 59102
Michels, Surrena
50 27th St W
Billings, MT 59102
Chase, Douglas
3307 Grand Ave
Billings, MT 59102
Follett, Jill
3307 Grand Ave
Billings, MT 59102
Zakrzewski, John
2045 Broadwater Ave
Billings, MT 59102
Details
Frank Michels, MD
Phone Number
(406) 237-5200
Office Locations
2019 Broadwater Ave
Billings, MT 59102
2019 Broadwater Ave Billings MT, 59102

Similar Plans

PremiumPlan NameCMS Rating
from $28
SilverScript Choice (PDP)
Details
from $22
Express Scripts Medicare - Saver (PDP)
Details
from $20
Humana Walmart Rx Plan (PDP)
Details
from $37
MedicareBlue Rx Standard (PDP)
Details
from $26
AARP MedicareRx Walgreens (PDP)
Details

Related Articles

Related Searches

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.

{}