2018 Humana Gold Plus H3533-027 (HMO) H3533-27-0 in NY from Humana | HealthPocket

Humana Gold Plus H3533-027 (HMO)

Medicare Advantage Plan for New York

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderHumana
Plan IDH3533-27-0
CMS Rating1
Plan TypeHMO
Annual Deductible$400.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium

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)
$6,700 In-network
Other health plan deductibles?
No
Health Plan Deductible
$1,000 In-network
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
Cost
Inpatient hospital coverage
$650 per stay
Outpatient hospital coverage
$500 per visit
Doctor visits
Primary:
$10 per visit
Specialist:
$50 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$80 per visit (always covered)
Urgent care:
$10-50 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
$0-100
Lab services:
$0-40
Diagnostic radiology services (e.g., MRI):
$10-500
Outpatient x-rays:
$10-100
Mental health services
$650 per stay
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 or 20%
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
$50
Routine foot care:
Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
12% per item
Prosthetics (e.g., braces, artificial limbs):
12% 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 H3533-027 (HMO)

StateNew York
CountyKings

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$6 copay$10 copay$6 copay
Tier 2: Non-Preferred Generic$16 copay$20 copay$16 copay
Tier 3: Preferred Brand Name$47 copay$47 copay$47 copay
Tier 4: Non-Preferred Brand Name$100 copay$100 copay$100 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$18 copay$30 copay$0 copay
Tier 2: Non-Preferred Generic$48 copay$60 copay$0 copay
Tier 3: Preferred Brand Name$141 copay$141 copay$131 copay
Tier 4: Non-Preferred Brand Name$300 copay$300 copay$290 copay
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
Not Rated
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
Not Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
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
Not Rated
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 H3533-027 (HMO) for New York

/
Stanchina, Joel
2146 Beverley Rd
Brooklyn, NY 11226
Muniz, Eric
710 Parkside Ave
Brooklyn, NY 11226
Bajaj, Shuchi
760 Parkside Ave
Brooklyn, NY 11226
Sultana, Sharmeen
1414 Newkirk Ave
Brooklyn, NY 11226
Conde, Marie
350 Ocean Ave
Brooklyn, NY 11226
Uduevbo, Jerry
2503 Church Ave
Brooklyn, NY 11226
Liverpool, Steven
322 Linden Blvd
Brooklyn, NY 11226
Schmidt, Marie
2324 Beverly Road
Brooklyn, NY 11226
Arnoff, Natalie
775 Flatbush Ave
Brooklyn, NY 11226
Fasolya, Mayya
2814 Clarendon Rd
Brooklyn, NY 11226
Ignacio, Erlinda
1095 Flatbush Ave
Brooklyn, NY 11226
Winiarsky, Raz
1414 Newkirk Ave
Brooklyn, NY 11226
Normil, Marie
1401 Newkirk Ave
Brooklyn, NY 11226
Noel, Ruthven
1416 Beverley Rd
Brooklyn, NY 11226
Khan, Nasrullah
29 Newkirk Plz
Brooklyn, NY 11226
Anglade, Albert
1515 Church Ave
Brooklyn, NY 11226
Sotnik, Regina
2146 Beverly Road
Brooklyn, NY 11226
Tellus, Francois
3101 Clarendon Rd
Brooklyn, NY 11226
Kerolle, Harold
1050 Ocean Ave
Brooklyn, NY 11226
Details
Joel Stanchina, MD
Phone Number
(718) 469-6600
Office Locations
2146 Beverley Rd
Brooklyn, NY 11226
2146 Beverley Rd Brooklyn NY, 11226

Similar Plans

PremiumPlan NameCMS Rating
from $0
Independent Health Encompass 65 (HMO)
Details
from $12
EnvisionRxPlus (PDP)
Details
from $0
Today's Options Premier 300 (PFFS)
Details
from $29
SilverScript Choice (PDP)
Details
from $17
Aetna Medicare Rx Select (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.

{}