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Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) is a HMO D-SNP 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 SNP-DE H6622-008 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP).
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 SNP-DE H6622-008 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.00. 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 $9250.00 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 SNP-DE H6622-008 (HMO D-SNP) features a yearly drug deductible of $615. Under this plan, you will have no copay for Tier 1 preferred generic and Tier 2 generic drugs when using standard pharmacies or preferred mail order for both 1-month and 3-month supplies. Standard mail order for these tiers requires a copay, ranging from $10 to $30 for Tier 1 and $20 to $60 for Tier 2 depending on the supply duration. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance applies to standard pharmacies, preferred mail order, and standard mail order. Tier 5 specialty drugs are limited to a 1-month supply.
Additional Benefits
The Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) offers comprehensive coverage with predictable cost-sharing, including a $2,230 copay per acute inpatient stay and a $2,080 copay per psychiatric stay with no coinsurance. Outpatient hospital care, primary care, and specialist visits require no copay but carry a 20% coinsurance. Emergency room visits have a $115 copay, which is waived if you are admitted, while urgently needed care is available with a $40 copay. Many supplemental benefits feature no copays and no coinsurance, including preventive care, home health services, and routine dental and vision care up to specified limits. Members also receive no-cost benefits for over-the-counter items, chronic illness meals, and up to 24 one-way transportation trips per year. Hearing aids and fitting evaluations are covered with no copay or coinsurance, helping you manage your overall health costs effectively.
Inpatient Hospital See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay. Unlimited additional acute days are covered, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan are covered with no copay and a 20% coinsurance, with prior authorization required. Covered benefits include outpatient hospital care, observation services, ambulatory surgical center visits, outpatient substance abuse sessions, and outpatient blood services.
Partial Hospitalization See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers ground ambulance services with a $335 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers primary care, specialist, mental health, psychiatric, and opioid treatment services with no copay and a 20% coinsurance. Physical, occupational, and speech-language therapy require a $35 copay and no coinsurance, while telehealth services range from a $0 to $40 copay with a 20% coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) offers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Although additional benefits like memory fitness and smoking cessation counseling are covered, multiple services including health education, in-home safety assessments, and nutritional benefits are not covered.
Hearing Services See details
Hearing services are covered by Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP), including routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance, excluding inner ear, outer ear, and over the ear types, while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers vision services with no deductibles and no copays, including one routine eye exam and one pair of eyeglasses or contact lenses per year up to a $200 combined limit. A 20% coinsurance applies to routine exams and contact lenses, prior authorization is required, and other eye exams, individual lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP), with exclusions for fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require no copay and 20% coinsurance, while other covered preventive and comprehensive dental services feature no copay and no coinsurance up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) with prior authorization and step therapy requirements. Covered Medicare Part B drugs, including chemotherapy, insulin, and other drugs, carry a 0% to 20% coinsurance, with insulin requiring a $35 copay and other drugs having no copay.
Dialysis Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) 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 SNP-DE H6622-008 (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with 20% coinsurance and no copay. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers diagnostic and radiological services with a 20% coinsurance, subject to prior authorization. Members will pay no copay for lab services, a $0 to $40 copay for diagnostic procedures, a $40 copay for outpatient X-rays, and a $200 copay for diagnostic radiological services.
Home Health Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) offers Cardiac Rehabilitation Services with no copay, subject to prior authorization. However, in practice some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 66 to 100, a $218 daily copay for days 21 to 65, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) partially covers other services, excluding highly integrated services for dual eligible SNPs. Covered options include acupuncture with no copay and 20% coinsurance, alongside over-the-counter items and chronic illness meal benefits featuring no copay and no coinsurance.
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