4

4 out of 5 stars* for plan year 2025

Plan ID: H0028-025

What You Need to Know:

  • Humana Gold Plus H0028-025 (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 $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $4,500 per year (in-network).
  • Humana Gold Plus H0028-025 (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $0.

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

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
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:
$0 $0 $0 $0 $0 $0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H0028-027
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): $4,500
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Elbert, Colorado: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
356 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 Elbert, Colorado: 30,650 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 $0.00 $0.00 $0.00
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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
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 $2.00 599 $7.00 783 $47.00 1085 $95.00 684 33%

Other Medicare Advantage Plans in Elbert, Colorado

Plan Name Type Premium MOOP Rx Deduct. Rating
Kaiser Permanente Senior Advantage Gold (HMO) (2023)Local HMO$3,000$0
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HumanaChoice H5216-077 (PPO) (2023)Local PPO *$4,000$-
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Aetna Medicare Prime (PPO) (2023)Local PPO$6,100$0
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Aetna Medicare Premier (PPO) (2023)Local PPO$7,550$0
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Aetna Medicare Prime 1 (PPO) (2023)Local PPO$6,700$0
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HumanaChoice H5216-078 (PPO) (2023)Local PPO$6,700$195
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Bright Advantage Choice (PPO) (2023)Local PPO$6,200$150
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Friday Health Plans Gold Plan (Cost) (2023)Cost *$6,700$-
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Bright Advantage Choice Plus (PPO) (2023)Local PPO$5,000$0
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Bright Advantage (HMO) (2023)Local HMO$4,400$0
5
AARP Medicare Advantage Walgreens (PPO) (2023)Local PPO$6,700$195
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Humana Gold Plus H0028-047 (HMO) (2023)Local HMO$5,500$0
4
Humana Value Plus H5216-195 (PPO) (2023)Local PPO$7,550$435
4
Bright Advantage Plus (HMO) (2023)Local HMO$3,250$0
5
AARP Medicare Advantage SecureHorizons Plan 1 (HMO) (2023)Local HMO$3,000$0
5
Bright Advantage Assist (HMO) (2023)Local HMO$6,700$445
5
AARP Medicare Advantage SecureHorizons Plan 2 (HMO) (2023)Local HMO$3,900$0
5
Humana Gold Choice H8145-123 (PFFS) (2023)PFFS$-$300
4
Aetna Medicare Prime (HMO) (2023)Local HMO$6,500$0
5
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$3,400$-
5
Humana Honor (PPO) (2023)Local PPO *$4,400$-
4
Aetna Medicare Elite Prime (HMO) (2023)Local HMO$5,600$0
New plan - not yet rated.
Kaiser Permanente Senior Advantage Core (HMO) (2023)Local HMO$4,400$95
5
Aetna Medicare Prime 1 (HMO) (2023)Local HMO$5,100$0
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Kaiser Permanente Senior Advantage Silver (HMO) (2023)Local HMO$3,400$50
5
Medicare Advantage Plans by Humana
HumanaChoice H5216-223 (PPO) (2023)Local PPO$5,500$0
4
HumanaChoice H5216-077 (PPO) (2023)Local PPO *$4,000$-
4
HumanaChoice H5216-078 (PPO) (2023)Local PPO$6,700$195
4
Humana Gold Plus H0028-047 (HMO) (2023)Local HMO$5,500$0
4
Humana Value Plus H5216-195 (PPO) (2023)Local PPO$7,550$435
4
Humana Gold Choice H8145-123 (PFFS) (2023)PFFS$-$300
4
Humana Honor (PPO) (2023)Local PPO *$4,400$-
4

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