4

4 out of 5 stars* for plan year 2024

Plan ID: H0028-016

What You Need to Know:

  • Humana Gold Plus H0028-016 (HMO) is a Medicare Advantage Health Maintenance Organization Local HMO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $26, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • Humana Gold Plus H0028-016 (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
  • This plan's Part D Initial Coverage Limit is $26.

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$26

Monthly Premium

Medicare Plan Features
Monthly Premium: $26.00
Part C Premium: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$26.00 $0 $26.00 $0 $26.00 $195.0 1.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H0028-017
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $7,550
Annual Deductible: $195 (Tier 1, 2 and 3 excluded from the Deductible.)
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Laclede, Missouri: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
105 members 4 out of 5 Stars. 4 out of 5 Stars. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,457 drugs
Number of Members Enrolled in this Plan in Laclede, Missouri: 2,762 members
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$0.00 $26.00 $0.00 $26.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$0.00 $19.50 $19.50 $13.00 $13.00 $6.50 $6.50
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
306 $6.00 599 $11.00 783 $47.00 1085 $99.00 684 29%

Other Medicare Advantage Plans in Laclede, Missouri

Plan Name Type Premium MOOP Rx Deduct. Rating
Anthem MediBlue Access (PPO) (2023)Local PPO$5,000$0
5
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$4,900$95
5
Aetna Medicare Premier (HMO) (2023)Local HMO$3,450$0
4
Aetna Medicare Premier Plus (HMO-POS) (2023)Local HMO$4,400$0
4
Aetna Medicare Premier Preferred (HMO) (2023)Local HMO$3,450$0
4
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$5,700$0
4
Aetna Medicare Elite (PPO) (2023)Local PPO$5,000$0
4
HumanaChoice H5216-032 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice R1532-002 (Regional PPO) (2023)Regional PPO$6,700$400
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,900$0
5
HumanaChoice H5216-033 (PPO) (2023)Local PPO$5,900$0
4
UnitedHealthcare Medicare Advantage Choice Plan 3 (Region (2023)Regional PPO$6,700$245
5
Humana Gold Choice H8145-120 (PFFS) (2023)PFFS *$-$-
4
UnitedHealthcare Medicare Advantage Choice Plan 2 (Region (2023)Regional PPO$6,700$295
5
Allwell Medicare Complement (HMO) (2023)Local HMO$3,400$445
New plan - not yet rated.
AARP Medicare Advantage Plan 2 (HMO-POS) (2023)Local HMO$3,700$100
5
Humana Gold Choice H8145-125 (PFFS) (2023)PFFS$-$195
4
Allwell Medicare (HMO) (2023)Local HMO$3,400$0
New plan - not yet rated.
AARP Medicare Advantage Plan 1 (HMO-POS) (2023)Local HMO$3,400$0
5
Anthem MediBlue Plus (HMO) (2023)Local HMO$3,400$0
4
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$445
New plan - not yet rated.
AARP Medicare Advantage Patriot (HMO-POS) (2023)Local HMO *$3,700$-
5
HumanaChoice R1532-001 (Regional PPO) (2023)Regional PPO *$3,900$-
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Humana Gold Plus H4623-001 (HMO) (2023)Local HMO$3,450$0
4
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Aetna Medicare Eagle (HMO) (2023)Local HMO *$3,450$-
4
Medicare Advantage Plans by Humana
HumanaChoice H5216-032 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice R1532-002 (Regional PPO) (2023)Regional PPO$6,700$400
4
HumanaChoice H5216-033 (PPO) (2023)Local PPO$5,900$0
4
Humana Gold Choice H8145-120 (PFFS) (2023)PFFS *$-$-
4
Humana Gold Choice H8145-125 (PFFS) (2023)PFFS$-$195
4
HumanaChoice R1532-001 (Regional PPO) (2023)Regional PPO *$3,900$-
4
Humana Gold Plus H4623-001 (HMO) (2023)Local HMO$3,450$0
4
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4

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