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What Is The Humana Gold Plus Plan

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Available Humana Medicare Advantage Plans

Humana Gold Choice Medicare Advantage – Should You Enroll?

Humana offers several kinds of Medicare Advantage plans, and they vary in terms of structure, costs and benefits available. Many plans offer dental and vision benefits, worldwide emergency care, and fitness benefits through SilverSneakers.

In general, Humana offers Medicare Advantage Prescription Drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage Plans without drug coverage. Its also worth noting that Humana Honor, the companys Medicare Advantage plan thats aimed toward U.S. military veterans, has been expanded into 47 states in its third year of operation.

Other plan offerings include the following types:

A health maintenance organization generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

Preferred provider organization plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you dont need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Humanas private fee-for-service plans allow you to see any Medicare-approved provider who accepts your Humana plan. You wont have to pick a primary doctor, and you wont need a referral to see a specialist.

Humana Gold Choice Pffs Plans


  • May pay extra for better prescription drugs
  • Dental and vision costs above exams may be extra

Humana takes it a step further and offers another type of plan if you want more flexibility. Humana Gold Choice PFFS plans have the most flexibility. These plans allow you to visit any doctor who accepts Humana. You can get all of the benefits from Medicare Part A, B and D with PFFS plans, as well. These plans have some great benefits for those who already have a doctor or who know what doctor is best for their medical needs.However, PFFS plans in every state through Humana typically have a monthly premium cost. Ultimately, PFFS offers the most flexibility and services for those who believe that they will need care from different doctors. These plans may have no monthly premium, but these will only have basic coverage. Some plans also include vision and dental coverage.With PFFS plans, you pick your options, doctors and facilities. You get the same coverage with Part A and Part B. But you may have to pay extra to enjoy this flexibility. However, its worth it to be able to go to different doctors and hospitals, as well as receive extra services.

Humana Medicare Advantage Plan Options

Humanas Medicare Advantage Plans vary among states and counties within those states. The provider supports four plan types: HMOs, PPOs, PFFS plans, and SNPs, but these are subject to area availability. You may only qualify for a Special Needs Plan if your diagnosis matches the list of required conditions.

Humana has robust telemedicine services and the company has waived out-of-pocket costs for all visits to its in-network provider, MDLIVE. This applies to online and phone consults for physical and behavioral health matters.

HMOs are typically the most affordable option, but many limit your ability to select the doctors and health care providers of your choice. With Humana HMO, SNP, and PFFS plans, primary care visits are often free or very low-cost, while PPOs tend to have higher copays on doctor visits and lower copays for emergencies. Take a look at some of the most popular options available for each of these types of plans.

Plan name

*Based on pricing in Orlando, FL

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Humana Walmart Value Rx Plan

Under the Humana Walmart Value Rx Plan, Humana teams up with Walmart, Walmart Neighborhood Markets, and Sams Club pharmacies as its preferred cost-sharing partners.

This lets Humana offer additional prescription savings to people who purchase their medications at Walmart.

The Humana Walmart Value Rx Plans benefits include:

  • $17.20 monthly plan premium nationwide
  • $0 deductible on tier 1 and 2 medications
  • $445 annual deductible on tiers 3 through 5 medications
  • in-store copays as low as $1 on a 30-day supply of certain generic drugs at Walmart, Walmart Neighborhood Markets, and Sams Club
  • copays as low as $3 on a 90-day supply of tier 1 preferred generics through Humanas mail-delivery pharmacy
  • more than 3,500 medications on the plans list of covered drugs

Before choosing the Humana Walmart Value Rx Plan, make sure you live near a Walmart location that features pharmacy services. While you are able to use other pharmacies under this plan, you wont get additional discounts if you dont use Humanas preferred cost-sharing partners.

Do Humana Plans Include Vision Coverage

Humana Gold Plus Home Health Care Benefits

Humana Medicare Advantage plans include some vision services.

Because Medicare Advantage plans offer the same basic coverage as original Medicare, Humana plans offer coverage for medically necessary vision treatments that maintain optical health. This may include surgery to remove cataracts or after an eye injury.

Medicare Part B contributes 80% of the cost of one pair of eyeglasses or set of contact lenses after cataract surgery after a person has reached the Part B deductible. Medicare Part B also covers an annual eye exam for diabetic retinopathy.

Some Humana Medicare Advantage plans include vision care such as eye exams, and additional available benefits include discounted eye exams and a yearly allowance for eyeglasses or contact lenses.

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Does Humana Cover Dental And Vision

Our dental plans and vision plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. Our dental plans and vision plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.

Competition: Humana Vs Unitedhealthcare

Humana and UnitedHealthcare are the Medicare Advantage plans with the broadest geographical coverage 84% of counties have Humana options, 66% have UnitedHealthcare, and 60% have both. UnitedHealthcare is the nations largest health insurer, with more than 14% market share.

UnitedHealthcare also has an exclusive partnership with AARP, giving it a unique advantage in a trusted brand affiliation. UnitedHealthcare has slightly higher average Star Ratings, but both companies offer online tools or apps and multiple channels for customer support. UnitedHealthcare helps members choose a plan with customized recommendations and cost estimators.

In a head-to-head comparison, the difference may come down to specific quality ratings in your local area and cost, which vary depending on where you are.


Humana has deep roots in care for older Americans. They offer a wide range of Medicare plans in the broadest geography of any insurer. Not only one of the biggest Medicare plans, Humana is one of the highest-rated overall. Not all their subsidiaries score as well for quality or customer satisfaction, so verifying the ratings of your specific options is important.

They also offer a range of ways to sign up and interact with the plan. Humana offers many extra benefits along with health and wellness programs.

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Pros And Cons Of Medicare Coverage From Humana

As with most plans, there are both pros and cons to opting for Humana.

As far as cons go, while the insurance company itself is available all over the country, certain plans may not be.

For example, SNPs are available in just 20 states and there are additional limitations on the type of condition covered like the state of Georgia, which technically has SNPs, but only for diabetes.

For the pros, one major advantage for Humana is its status as a national company with availability across the U.S. This can offer more security than you might get from a more regional option and ensures that some form of coverage is likely available where you live.

Another pro is that, with some exceptions, Humanas customer satisfaction tends to be high. In July 2021, a J.D. Power pharmacy study ranked Humana first in customer satisfaction for mail order.

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So how do we make money? Our partners compensate us. This may influence which products we review and write about , but it in no way affects our recommendations or advice, which are grounded in thousands of hours of research. Our partners cannot pay us to guarantee favorable reviews of their products or services.Here is a list of our partners.

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Humana Launching 72 New Medicare Plans For 2022

Humana is launching 72 new Medicare Advantage plans for 2022 across hundreds of additional counties, the insurer announced Friday.

This includes 42 new Medicare Advantage Prescription Drug plans, three MA-only plans, and 27 special needs plans, Humana said. The company will expand its HMO Medicare plans into 115 new counties and PPO Medicare plans into 162 new counties.

Humana also intends to bring its dual special needs plans to 268 new counties. The overall expansion will allow it to reach 4 million additional Medicare eligibles.

After considering the needs of our members and how we could offer them more for 2022, we designed our Medicare plans to address peoples whole-life needswith a particular focus on their most important health care needs and delivering the human care our members expect from Humana, said Alan Wheatley, president of Humana’s Retail Segment, in a statement.

RELATED: Here’s what major national payers are offering in Medicare Advantage for 2022

Our 2022 product continuum evolves our Medicare capabilities to meet the personalized needs of individuals across the country as we address health equity in the diverse populations we serve,” Wheatley said.

Medicare open enrollment begins on Oct. 15, and insurers are now outlining their offerings for the coming plan year.


What Are Medicare Advantage Plans

Medicare Advantage plans, known as Part C, are all-in-one packages for Original Medicare services. They cover Part A and Part B, and most include Part D as well. Some plans also offer benefits that arent available with Original Medicare, such as vision, hearing and dental care.

The most common Medicare Advantage plans are:

  • Health maintenance organization plans
  • Preferred provider organization plans
  • Private fee-for-service plans
  • Special needs plans *

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What States Offer Humana Medicare Advantage Plans

Humana offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska.

Although there is wide availability throughout the country, specific types of plans and coverage options may only be offered in certain areas. This means that if your relative in another state has a Humana plan, the same plan might not be available to you.

What Medicare Part D Prescription Drug Plans Are Available From Humana

Group ID and Benefit Number are Required on all Humana MA ...

Medicare plans available from Humana also include stand-alone Medicare Part D Prescription Drug Plans, which provide prescription drug benefits if youre enrolled in Original Medicare . Each of these plans must provide minimum benefits mandated by the Medicare program for example, each Medicare Prescription Drug Plan must cover at least two prescription drugs from certain required drug classes. Like Medicare Advantage Prescription Drug plans, these plans use a formulary, or list of covered prescription drugs, to determine coverage the plan may change its formulary at any time, but it must notify you before any change occurs.

Stand-alone Medicare Part D Prescription Drug Plans offered by Humana in your vicinity may include the following:

  • The Humana Walmart Rx Plan is an economical option that features low premiums, no deductible on Tier 1 and Tier 2 prescription drugs, and low cost-sharing if you use a Walmart, Walmart Neighborhood Market, or Sams Club pharmacy.
  • The Humana Preferred Rx Plan may offer preferred cost-sharing if you use certain Walmart, Walmart Neighborhood Market, or Sams Club pharmacies and has a deductible.
  • The Humana Enhanced Plan features no deductible and a comprehensive prescription drug formulary.

If you qualify for Extra Help under the Medicare Part D program, you might not have to pay a premium for your Medicare Prescription Drug Plan.

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Humana Gold Plus H5619

Humana Gold Plus H5619-113 H5619-113-000 is a 2022 Medicare Advantage plan without drug coverage provided by Humana. It has a premium of $0.00.

More details on this plan are provided below. If you have questions, donât hesitate to use our site to reach out to a licensed Medicare agent for help today. Alternatively, if you know what plan you want, you can enroll online yourself using our site as well.

Plan Basics

What Medicare Advantage Plans Are Available From Humana

Medicare Advantage plans are an alternative way to get all the coverage of Original Medicare in a different way. Many plans, known as Medicare Advantage Prescription Drug plans, also include prescription drug coverage , letting you get all of your Medicare benefits under one convenient plan. Some of these Medicare Advantage plans from Humana may include extra coverage for routine vision, dental, hearing care, and even wellness programs. Depending on where you live, you may be eligible to enroll in one of these types of Humana Medicare Advantage plans:

  • Humana Gold Plus Health Maintenance Organization plans, which require you to use network providers and get referrals from your primary care doctor for specialist care.
  • Humana Choice Preferred Provider Network plans, which pay for more of your costs when you use network providers. However, you may have the option to use non-network providers but you might pay higher copayments and coinsurance costs if you do go out-of-network. You dont need referrals for specialist services.*
  • Humana Gold Choice Private Fee-For-Service plans, which let you use providers that accepts your plans terms and conditions and agree to treat you. Keep in mind that providers that have not contracted with the plan are not required to treat you .

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Humana Medicare Advantage Service Area

Humana offers Medicare Advantage plans in 47 states and Puerto Rico, and Medicare prescription drug plans in all 50 states, Washington, D.C., and Puerto Rico. Humana Medicare Advantage plans are available in 85% of U.S. counties the most of any provider.

For the 2022 plan year, Humana expanded its HMO offerings into 115 new counties and introduced local PPO plans in 162 new counties. The company also expanded D-SNPs into 268 new counties .

Overall, Humana is the second-largest health insurer among for-profit health plans . Nearly 4.9 million Medicare beneficiaries are enrolled in a Humana Medicare Advantage plan.

What To Expect With A Humana Medicare Advantage Plan

Humana Medicare Advantage Your Journey Starts Here | Humana

Humana offers the following several types of Medicare Advantage plans, with plans available in all 50 states, Washington, DC, and Puerto Rico.

  • Health maintenance organizations keep costs low by keeping care restricted within an approved provider network.
  • Preferred provider organizations offer more choice of providers, but at a higher out-of-pocket cost.
  • Special needs plans target certain patient populations, such as those eligible for both Medicare and Medicaid, and those diagnosed with certain conditions .

Although Humanas HMOs like most insurers tend to be the most affordable plans, the company does offer a decent array of other types of plans. For example, Humana also offers a PFFS plan. This plan offers enrollees a great amount of freedom , but it is the most expensive.

Humana Medicare Advantage plans are similar to the all-in-one group health insurance you might already be used to. When you receive care, youll have to pay a copay at the time of service. Your provider will then file a claim with Humana, and Humana will reimburse your provider directly. If youre responsible for any leftover costs, youll receive a bill from your provider.

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Compare Common Medicare Advantage Plans Side By Side

This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult your doctor to determine what is right for you.

Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Humana is also a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal.

Some links on this page may take you to Humana non-Medicare product or service pages or to a different website.


Humana Medicare Advantage 2021

Many or all of the products featured here are from our partners who compensate us. This may influence which products we write about and where and how the product appears on a page. However, this does not influence our evaluations. Our opinions are our own. Here is a list ofour partnersandhere’s how we make money.

Humana is the second-largest provider of Medicare Advantage plans , and the provider thats available to the most people, with plans offered in more than eight out of 10 U.S. counties. The vast majority of its Medicare Advantage customers are in high-quality plans rated 4 stars or higher by the Centers for Medicare & Medicaid Services, and the company offers some nice perks with many plans.

Although most of Humanas Medicare beneficiaries are in high-rated plans, some contracts get lower scores than others, so its worth doing your research before you sign on.

Heres what you should know about Humana Medicare Advantage.

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