Humana Gold Choice H8145-126 (PFFS) Medicare Advantage Plan H8145-126 • 2027 • Jefferson County, MO
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Jefferson County, MO
- Local Enrollment
- 0 beneficiaries in Jefferson County
Humana Gold Choice H8145-126 (PFFS) Introduction
Humana Gold Choice H8145-126 is a Medicare Advantage PFFS plan offered by Humana. It uses a Medicare Private Fee-for-Service (PFFS) provider network and comes without prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. CMS Plan ID H8145-126 identifies this plan.
You must live in Jefferson County, Missouri to enroll in this plan. CMS reports 0 beneficiaries enrolled in this plan in Jefferson County. For assistance with this plan, new members can call (888)873-0686 (TTY 711).
Compare Similar Plans in Jefferson County
Compare this plan with the most-enrolled other PFFS plan available in Jefferson County, Missouri. Enrollment is based on CMS local enrollment data.
| Plan Detail | Humana Gold Choice H8145-126 | Humana Gold Choice H8145-006 |
|---|---|---|
| CMS Plan ID | H8145-126-0 |
H8145-006-0 |
| Local Enrollment | 0 | 20 |
| Monthly Premium | $0.00 | $60.00 |
| Medical Deductible | Coming soon | Coming soon |
| Maximum Out-of-Pocket | $9,850.00 | $7,800.00 |
| Part B Giveback | Coming soon | Coming soon |
| Primary Care | Coming soon | Coming soon |
| Specialist | Coming soon | Coming soon |
| Part D Deductible | Not Applicable | $700.00 |
| CMS Star Rating | Not yet rated | Not yet rated |
| Dental | Coming soon | Coming soon |
| Vision | Coming soon | Coming soon |
| Hearing | Coming soon | Coming soon |
Plan Benefits
Humana Gold Choice H8145-126 has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H8145-126.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8145-126-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: $20 copay - Specialist
- In-network: $40 copay
Out-of-network: $50 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0 copay - Telehealth benefit
- In-network: $0-$40 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: 95% coinsurance - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$360 copay
Out-of-network: $0 copay, 30% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: $20-$50 copay, 30% coinsurance - Outpatient x-rays
- In-network: $0-$145 copay
Out-of-network: $20-$50 copay, 30% coinsurance - Diagnostic tests and procedures
- In-network: $0-$175 copay
Out-of-network: $20-$50 copay, 30% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$485 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
$485 per day for days 1-5
$0 per day for days 6-90
$0 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
$0 per day for days 1-20
$221 per day for days 21-100
$0 per stay - Ground ambulance
- In-network: $325 copay
Out-of-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $20 copay
Out-of-network: 30% coinsurance - Outpatient group therapy
- In-network: $20 copay
Out-of-network: 30% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$485 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
$485 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $30 copay
Out-of-network: 30% coinsurance - Occupational therapy
- In-network: $30 copay
Out-of-network: 30% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay, 10%-20% coinsurance
Out-of-network: 20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- 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: 30% coinsurance
Dental Services
- 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
- In-network: 0%-30% coinsurance
Out-of-network: 0%-30% coinsurance - Endodontics
- In-network: 0%-30% coinsurance
Out-of-network: 0%-30% coinsurance - Restorative services
- In-network: 0%-30% coinsurance
Out-of-network: 0%-30% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: 0%-30% coinsurance
Out-of-network: 0%-30% coinsurance
Vision Services
- 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
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: 95% coinsurance - Fitting/evaluation
- In-network: $0 copay
Out-of-network: 95% coinsurance - Prescription hearing aids
- In-network: $575-$750 copay
Out-of-network: 95% coinsurance - OTC hearing aids
- In-network: $0 copay
Out-of-network: 95% coinsurance
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Humana Gold Choice H8145-126 as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H8145)
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for Humana
- Website
- Humana Plan Page
- Providers
- Humana Providers Page
- Formulary
- Humana Formulary Page
- Pharmacy
- Humana Pharmacy Page
- New Member Health Plan Help
- (888)873-0686
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Humana (official source) | http://www.humana.com/medicare | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.