pay your Medicare Part Bpremium. This premium is normally taken out of your Social Security check 
each month. 
Benefits, premiums and/or copayments/co-insurance may change on January 1, 2023. 
Except in emergency or urgent situations, we do not cover services by out-of-network providers 
(doctors who are not listed in the provider directory). 2022 
H1036_SB_MAPD_HMO_265001_2022_M H1036265001SB22 Summary of Benefits 
Humana Gold Plus H1036-265 (HMO) 
Greater Tampa Bay 
Tampa Metro Area