Humana Gold Choice H8145-163 (PFFS) in Clinton County, Pennsylvania — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Humana Gold Choice H8145-163 (PFFS) (H8145-163) is a $0-premium Medicare Advantage PFFS from Humana Inc. available in Clinton County, Pennsylvania in 2026, with a 3.5-star overall rating, a $1,500 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Humana Inc. |
|---|---|
| Plan name | Humana Gold Choice H8145-163 (PFFS) |
| Contract ID | H8145 |
| Plan ID | 163 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA |
| Plan type | PFFS |
| SNP | No |
| Monthly consolidated premium | — |
| Part C premium | $155.00 |
| Part D basic premium | — |
| Part D total premium | — |
| Annual Part D deductible | — |
| Maximum out-of-pocket (in-network) | $1500.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PFFS plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $1,500 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Clinton County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Clinton County
The CMS CY2026 Landscape file lists 75 Medicare Advantage plans in Clinton County, Pennsylvania, of which 0 carry a 5.0-star overall rating and 37 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $226.00 per month, and in-network out-of-pocket maximums range from $1500.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Clinton County, Pennsylvania.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H8145-163.
- Call the plan (Humana Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H8145-163 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H8145-163, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 8145 are the contract number issued to the organization, and the three-digit 163 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is Humana Gold Choice H8145-163 (PFFS) an HMO or PPO?
Humana Gold Choice H8145-163 (PFFS) is a PFFS Medicare Advantage plan.
Does Humana Gold Choice H8145-163 (PFFS) include prescription drug coverage?
Humana Gold Choice H8145-163 (PFFS) does not include Part D prescription drug coverage in its consolidated benefits.
What is the maximum out-of-pocket cost for Humana Gold Choice H8145-163 (PFFS)?
The 2026 in-network maximum out-of-pocket limit for Humana Gold Choice H8145-163 (PFFS) is $1500.00, per the CMS CY2026 Landscape file.
What counties offer Humana Gold Choice H8145-163 (PFFS) (H8145-163)?
Humana Gold Choice H8145-163 (PFFS) (H8145-163) is offered in 63 Pennsylvania counties: Adams County, Allegheny County, Armstrong County, Beaver County, Bedford County, Berks County, Blair County, Bradford County, Bucks County, Butler County, Cameron County, Carbon County, Centre County, Chester County, Clarion County, Clearfield County, Clinton County, Crawford County, Cumberland County, Dauphin County, Delaware County, Elk County, Erie County, Fayette County, Forest County, Franklin County, Fulton County, Greene County, Huntingdon County, Jefferson County, Juniata County, Lackawanna County, Lancaster County, Lawrence County, Lebanon County, Lehigh County, Luzerne County, Lycoming County, McKean County, Mercer County, Mifflin County, Monroe County, Montgomery County, Montour County, Northampton County, Perry County, Philadelphia County, Pike County, Potter County, Schuylkill County, Snyder County, Somerset County, Sullivan County, Susquehanna County, Tioga County, Union County, Venango County, Warren County, Washington County, Wayne County, Westmoreland County, Wyoming County, and York County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.