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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 2025, 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 2025.
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 $50.60. 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 $590.00 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 $9350.00 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) plan has a $590.00 deductible for prescription drugs. After meeting the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. If you qualify for the low-income subsidy, your monthly Part D premium is $50.60. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays require prior authorization and have a copay of $2,160 per admission, while outpatient services, including observation and ambulatory surgical center services, have a 20% coinsurance. Emergency services have a $110 copay, and primary care visits have a 20% coinsurance, while chiropractic services have no copay. Preventive services include an annual physical exam with no copay. Hearing services include hearing exams with at most 20% coinsurance, and routine hearing exams with no copay. Vision services provide eye exams with no copay and eyewear with no copay. Dental services offer coverage for Medicare Dental Services with 20% coinsurance, and other dental services with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, the copay is $2,160 per admission or stay, and additional days are covered with no copay. For Inpatient Hospital Psychiatric, the copay is $2,036 per admission or stay; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance. Ambulatory Surgical Center Services and Outpatient Substance Abuse Services have a coinsurance of 20%. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan, with an $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Ground ambulance services have a $315 copay, and air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations have no copay, and are limited to 12 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan. Emergency Services has a $110 copay, Urgently Needed Services has a $45 copay, and Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay. There is no coinsurance for any of these services.
Primary Care See details
The Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan covers primary care physician services with 20% coinsurance, and chiropractic services with no copay, and occupational therapy services with a $35 copay. The plan also covers additional telehealth benefits with 20% coinsurance and a copay between $0 and $45.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, in addition to other preventive services that may have a copay. Additional services such as Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS) are not covered.
Hearing Services See details
The Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan covers hearing exams with at most 20% coinsurance, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with no copay, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with no copay and 20% coinsurance, and eyewear. Eyewear includes contact lenses with no copay and 20% coinsurance, and eyeglasses (lenses and frames) with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services with a $2,000 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered under the Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%, and no copay.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus SNP-DE H6622-008 (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 20% coinsurance, while Diabetic Supplies have a 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a coinsurance of at most 20% and a copay that can be up to $45, while Lab Services have a coinsurance of at most 20% and no copay. Diagnostic Radiological Services have a coinsurance of at most 20% and a copay that can be up to $300, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a coinsurance of at most 20% and a $45 copay.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and coinsurance applies for covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20 and 66-100, there is no copay, and for days 21-65, the copay is $214.
Other Services See details
Other Services includes acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a 20% coinsurance and requires prior authorization, while the meal benefit has no copay and requires prior authorization. OTC items are covered with a maximum benefit of $1200 per year.
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