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Humana Gold Plus H6622-014 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-014 (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 H6622-014 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-014 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Northeast Ohio. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-014 (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 H6622-014 (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 H6622-014 (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 $4150.00 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 H6622-014 (HMO-POS) plan has a $250 deductible. After the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you can expect to pay $5 or $20 for preferred generic drugs, depending on the pharmacy. For preferred brand drugs, you will pay 48% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Gold Plus H6622-014 (HMO-POS) plan offers a range of benefits with varying costs. Hospital stays have a copay that varies by length of stay, while outpatient services like primary care and preventive exams have no copay. Emergency services, along with ambulance and transportation, are covered, but do have copays. This plan provides coverage for hearing, vision, and dental services, with copays for exams and varying costs for hearing aids and dental procedures. Additional benefits include home health services, and coverage for durable medical equipment, as well as other services like acupuncture and OTC items, with associated copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $360 for days 1-7 and 1-6 respectively, and no copay for days 8-90 and 7-90. Additional Days for Inpatient Hospital-Acute is covered with no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $360, observation services with a $360 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $35 and $100 for individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $315 copay for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are also covered with no copay, up to 24 one-way trips per year, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Humana Gold Plus H6622-014 (HMO-POS) plan. Emergency Services have a $140 copay and no coinsurance. Urgently Needed Services have a $65 copay and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $140 copay and no coinsurance.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $15 and $55, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a copay of $35, Physical Therapy and Speech-Language Pathology Services with a copay between $15 and $55, Additional Telehealth Benefits with a copay between $0 and $65, and Opioid Treatment Program Services with a copay between $35 and $100. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, as well as Additional Preventive Services such as wigs for hair loss related to chemotherapy, Additional Sessions of Smoking and Tobacco Cessation Counseling, and Fitness Benefits, all with no copay. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services. Also covered are Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with a $35 copay, and routine hearing exams are covered with no copay. Fitting and evaluation for hearing aids have no copay, while prescription hearing aids have a copay between $399 and $999. OTC hearing aids are covered, with a maximum of $100 every three months.
Vision Services See details
The Humana Gold Plus H6622-014 (HMO-POS) plan covers vision services, including eye exams with a copay between $0 and $35, and eyewear with no copay, up to a combined maximum of $150 per year; however, eyeglass lenses, eyeglass frames, and upgrades are not covered. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $35 copay, and other dental services with a $3,000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, and prosthodontics fixed, and oral and maxillofacial surgery are covered with no copay. Fluoride treatment, prosthodontics removable, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Humana Gold Plus H6622-014 (HMO-POS) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H6622-014 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies have a coinsurance between 10% and 20% with no copay, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay between $0 and $105, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $475, Therapeutic Radiological Services with a copay up to $35 and a coinsurance of 20% or more, and Outpatient X-Ray Services with no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-014 (HMO-POS) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any specific services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H6622-014 (HMO-POS) plan, but require prior authorization. For days 1-20, the copay is $20, and for days 21-100, the copay is $214.
Other Services See details
Under the Humana Gold Plus H6622-014 (HMO-POS) plan, acupuncture has a $35 copay, with a limit of 20 treatments per year, and over-the-counter (OTC) items are covered with a maximum benefit of $100 every three months. Meal benefits are covered with no copay. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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