Humana Gold Choice H8145-126 (PFFS)
Medicare Advantage Plan H8145-126 • 2026
Humana Gold Choice H8145-126 (PFFS) Medicare Advantage Plan H8145-126 • 2026
The Medicare Advantage plan identified by CMS Plan ID H8145-126 (Humana Gold Choice H8145-126) is a PFFS Part C plan offered by Humana for the 2026 plan year. It uses a Medicare Private Fee-for-Service (PFFS) provider network and comes without drug coverage (Part D prescriptions).
Humana Gold Choice H8145-126 Overview
Plan Overview for H8145-126-0 |
|
|---|---|
| CMS Plan ID: | H8145-126-0 |
| Plan Type: | PFFS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $6700.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | See List |
| Enrollment (Nationwide) | 1,024 beneficiaries |
| Provided By: | Humana |
Plan Availability
Humana Gold Choice H8145-126 (H8145-126-0) is available in the following locations (click to open):
Coverage Overview for Humana Gold Choice H8145-126
With a monthly premium of $0.00, this Private Fee-for-Service Medicare Advantage plan covers Medicare Part A and Part B services and allows access to Medicare-approved providers who agree to the plan’s terms. Referrals are not required, and provider participation is determined at the time services are received.
Primary care visits have a $0 copay | Out-of-network: $20 copay, specialist visits come with a $40 copay | Out-of-network: $50 copay, lab services cost {lab_services_cost}, urgent care services carry a $50 copay, and ambulance transportation is $250 copay | Out-of-network: $250 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $6700.00. After this limit is reached, covered services are fully paid.
This plan is listed by CMS under Plan ID {title_plan_id}. A breakdown of cost sharing is provided below.
Cost Sharing Expenses
Cost-sharing for Humana Gold Choice H8145-126 includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H8145-126.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $20 copay |
| Specialist: | In-network: $40 copay | Out-of-network: $50 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$50 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | Not covered |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health transportation (non-emergency): | Not covered |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$200 copay, 20% coinsurance | Out-of-network: $0 copay, 30% coinsurance |
| Lab services: | In-network: $0-$50 copay | Out-of-network: $20-$50 copay, 30% coinsurance |
| Outpatient x-rays: | In-network: $0-$50 copay | Out-of-network: $20-$50 copay, 30% coinsurance |
| Diagnostic tests and procedures: | In-network: $0-$50 copay | Out-of-network: $20-$50 copay, 30% coinsurance |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $90 copay |
| Worldwide emergency care: | $90 copay |
| Urgent care: | $50 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $360 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $360 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 | $150 per day for days 21-100 | Out-of-network: | $0 per day for days 1-20 | $150 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $250 copay | Out-of-network: $250 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $30 copay | Out-of-network: $50 copay |
| Outpatient group therapy: | In-network: $30 copay | Out-of-network: $50 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $360 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $360 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $25 copay | Out-of-network: $50 copay, 30% coinsurance |
| Occupational therapy: | In-network: $25 copay | Out-of-network: $50 copay, 30% coinsurance |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay, 10%-20% coinsurance | Out-of-network: 20% coinsurance |
| Durable medical equipment: | In-network: $0 copay, 20% coinsurance | Out-of-network: 50% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| 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 |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| 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 copay | Out-of-network: $0 copay |
| Endodontics: | In-network: $0 copay | Out-of-network: $0 copay |
| Restorative services: | In-network: $0 copay | Out-of-network: $0 copay |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: $0 copay |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| 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 |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay |
| Prescription hearing aids: | In-network: $699-$999 copay | Out-of-network: $699-$999 copay |
| OTC hearing aids: | In-network: $0 copay | Out-of-network: $0 copay |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| 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 Ratings
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2026 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 |
How much does plan H8145-126 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The 2026 in-network MOOP is $6700.00. Once this limit is reached, covered in-network costs are fully covered.
What is the total enrollment for plan H8145-126?
The plan has 1,024 enrolled beneficiaries according to CMS.
Is there a Part D deductible for this plan?
The plan’s Part D deductible is $0.00, applied to covered prescription drug costs.
Contact Information for Humana
| Contact Type | Details |
|---|---|
| Website: | Humana Plan Page |
| New Members: | 1-888-873-0686 |
| Existing Members: | 1-800-457-4708 |
| Plan Address: | 101 E Main Street | Louisville, KY 40202 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed June 13, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed June 13, 2026
- CMS.gov, Plan Benefits Package — Last accessed June 13, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed June 13, 2026
Data sources and methodology documentation..
- Humana (official source), http://www.humana.com/medicare — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
MedicarePlans.com is an independent informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
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.