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Humana Gold Plus H6622-013 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-013 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H6622-013 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-013 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Columbus Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-013 (HMO-POS) 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 H6622-013 (HMO-POS).
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 H6622-013 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $3.00. You must continue to pay paying your reduced 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 $250.00 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 $4500.00 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 H6622-013 (HMO-POS) plan has a $250 deductible for prescription drugs. After the deductible, you'll pay varying copays or coinsurance amounts depending on the drug tier and the pharmacy you use. For example, you may pay a $5 copay for a preferred generic drug at a standard pharmacy, or 50% coinsurance for a preferred brand drug. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. However, this plan's premium may be reduced if you qualify for the low-income subsidy, also known as LIS or "Extra help".
Additional Benefits
The Humana Gold Plus H6622-013 (HMO-POS) plan offers a range of benefits with varying costs. Many services have no copay, including primary care visits, preventive services, and home health services. The plan covers hospital stays, outpatient services, and emergency services, with copays ranging from $0 to $460 depending on the service. Additional benefits include dental, vision, and hearing coverage, as well as coverage for medical equipment and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits for Humana Gold Plus H6622-013 (HMO-POS) include coverage for Inpatient Hospital-Acute, with a copay of $460 for days 1-5 and no copay for days 6-90, and Inpatient Hospital Psychiatric, with a copay of $460 for days 1-4 and no copay for days 5-90. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $460, individual and group outpatient substance abuse sessions have a copay between $35 and $100, and outpatient blood services have no copay. Ambulatory Surgical Center (ASC) Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H6622-013 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a $315 copay, and transportation services with no copay. 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 Humana Gold Plus H6622-013 (HMO-POS). Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a $55 copay and no coinsurance; Worldwide Emergency Services have a $125 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
The Humana Gold Plus H6622-013 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $10 and $40. The plan also covers physician specialist services with a $35 copay, mental health specialty services with a minimum $35 copay, and physical therapy and speech-language pathology services with a copay between $10 and $40. Additionally, additional telehealth benefits are covered with a copay between $0 and $55, and opioid treatment program services are covered with a minimum copay of $35 and a maximum copay of $100.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional services that may have a copay. Additional services like health education, in-home safety assessment, and more are not covered.
Hearing Services See details
Hearing Services includes coverage for hearing exams with a $35 copay. Routine hearing exams are covered with no copay for one visit every year, and the plan also covers fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a copay between $399 and $999 for prescription hearing aids of all types, but not for inner ear, outer ear, or over the ear hearing aids. OTC hearing aids are covered, with a maximum benefit of $100 every three months.
Vision Services See details
Vision services include coverage for eye exams with a copay between $0 and $35, and eyewear with no copay. Contact lenses and eyeglasses (lenses and frames) are covered, and there is a combined maximum plan benefit of $300 per year for eyewear.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $35 copay, 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 Oral and Maxillofacial Surgery with a $0 copay, and Prosthodontics, fixed, with a 30% coinsurance. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered. The plan has a maximum benefit of $5,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Humana Gold Plus H6622-013 (HMO-POS) plan, and prior authorization is required. The plan has a $35 copay for Medicare Part B Insulin Drugs, with coinsurance ranging from 0% to 20% depending on the drug.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance; Diabetic Supplies have a 10-20% coinsurance with no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, and radiological services, are covered. Diagnostic procedures/tests have a copay between $0 and $110, lab services have no copay, diagnostic radiological services have a copay up to $330, therapeutic radiological services have a copay up to $35 and 20% coinsurance, and outpatient X-Ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-013 (HMO-POS) plan 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 by the Humana Gold Plus H6622-013 (HMO-POS) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, the copay is $10 per day, and for days 21-100, the copay is $214 per day.
Other Services See details
Humana Gold Plus H6622-013 (HMO-POS) covers acupuncture with a $35 copay, and covers over-the-counter items with a maximum benefit of $100 every three months. The plan also covers a meal benefit with no copay. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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