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Humana Gold Plus H6622-007 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-007 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H6622-007 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-007 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in MT. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-007 (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus H6622-007 (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Humana Gold Plus H6622-007 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5700.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Humana Gold Plus H6622-007 (HMO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a one-month or three-month supply at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also highly affordable, costing an $8 copay for a one-month supply at standard pharmacies and preferred mail order, or no copay for a three-month supply via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply across standard pharmacies and mail order options. Non-preferred drugs in Tier 4 require a 50% coinsurance, while Tier 5 specialty drugs have a 25% coinsurance. This Medicare plan structure helps you manage prescription costs by choosing the right tier and pharmacy options.
Additional Benefits
The Humana Gold Plus H6622-007 (HMO) plan offers affordable medical coverage with no copay for primary care doctor visits and a $45 copay for specialist visits, both with no coinsurance. Preventive services, home health care, and routine lab tests are also covered with no copays or coinsurance. For inpatient hospital stays, members pay a $350 daily copay for days 1 through 5 and no copay for days 6 through 90, while emergency room visits carry a $130 copay that is waived if admitted. Supplemental benefits include routine hearing exams and preventive dental care with no copays or coinsurance, alongside dental coverage up to a $1,000 annual limit. Vision care features eye exams with no copay to a $45 copay, alongside eyewear covered up to a $100 yearly limit. For specialized needs, dialysis and durable medical equipment are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H6622-007 (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 5 and no copay for days 6 through 90. While acute care includes unlimited additional days at no copay, this plan does not cover additional psychiatric days, room upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Humana Gold Plus H6622-007 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copays. Outpatient hospital services require a copay of $0 to $350, observation services have a $350 copay per stay, and outpatient substance abuse sessions require a copay of $0 to $35.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H6622-007 (HMO) with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-007 (HMO) covers Medicare-covered ground ambulance services with a $335 copay and air ambulance services with a $500 copay, both requiring prior authorization with no coinsurance. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
Humana Gold Plus H6622-007 (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-007 (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while podiatry services and routine chiropractic care are not covered.
Preventive Services See details
Humana Gold Plus H6622-007 (HMO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and a memory fitness benefit. This benefit is partially covered because several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional or dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home or bathroom safety devices, and counseling.
Hearing Services See details
Humana Gold Plus H6622-007 (HMO) covers routine hearing exams and unlimited fitting evaluations with no deductible, no copay, and no coinsurance, while Medicare-covered exams require a $45 copay and no coinsurance. Prescription hearing aids are partially covered with no deductible, no coinsurance, and copays ranging from $699 to $999 for up to two devices per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Humana Gold Plus H6622-007 (HMO), featuring a $0 to $45 copay and no coinsurance for eye exams, and no copay or coinsurance for eyewear up to a $100 annual limit. While routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered with no deductible, other eye exam services, standalone eyeglass lenses, standalone eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-007 (HMO) offers partially covered dental services up to a $1,000 annual limit, featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care. Advanced services require no copay and 0% to 40% coinsurance, but fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-007 (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H6622-007 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H6622-007 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance, with prior authorization required for most items.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-007 (HMO) covers diagnostic services with no coinsurance, offering no copay for lab services and a copay ranging from $0 to $95 for diagnostic procedures and tests. Covered radiological services require prior authorization and feature no copay for outpatient X-rays, a minimum $0 copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Humana Gold Plus H6622-007 (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-007 (HMO) covers some cardiac rehabilitation services with no coinsurance, though cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice. Prior authorization is required, and these non-covered services carry copays of $15 for pulmonary, $25 for SET for PAD, and $30 for cardiac and intensive cardiac rehabilitation.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H6622-007 (HMO) with no coinsurance, featuring no copay for days 1 to 20 and 51 to 100, and a $218 daily copay for days 21 to 50. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-007 (HMO) partially covers other services, offering acupuncture for a $45 copay and no coinsurance for up to 20 treatments per year, alongside chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan benefit.
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