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Humana Gold Plus H6622-021 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-021 (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 H6622-021 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-021 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Northern Kentucky 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 H6622-021 (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 H6622-021 (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 H6622-021 (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 $2.00. 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 $6300.00 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 H6622-021 (HMO-POS) plan has a $250 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $5 copay at a standard or preferred mail pharmacy, while standard generic drugs have a $47 copay. Brand-name drugs have 50% coinsurance, and non-preferred drugs have 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Humana Gold Plus H6622-021 (HMO-POS) plan offers a range of benefits, including inpatient hospital stays with a $460 copay per admission for the first five days, and outpatient services with varying copays. This plan also covers emergency services with a $125 copay, along with primary care visits for a $10 copay. Additional benefits include coverage for preventive services with no copay for an annual physical exam, and vision services with no copay for routine eye exams and eyewear. Dental services are covered, with no copay for many services, and hearing services are also covered.
Inpatient Hospital See details
Inpatient hospital stays are covered, including acute and psychiatric care, with a copay of $460 per admission for days 1-5 and no copay for days 6-90. Additional days for inpatient hospital-acute have no copay. Non-Medicare covered stays and upgrades for inpatient hospital-acute and additional days for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $460, observation services with a $460 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $60 and $100 for individual or group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H6622-021 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a copay of $315, and transportation services to plan-approved health-related locations with no copay for up to 24 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 under the Humana Gold Plus H6622-021 (HMO-POS) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a $55 copay and no coinsurance, and Worldwide Emergency Services have a $125 copay and no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Humana Gold Plus H6622-021 (HMO-POS) plan covers primary care physician services with a $10 copay, chiropractic services with a $20 copay, and occupational therapy services with a $10-$40 copay. The plan also covers physician specialist services with a $45 copay, mental health and psychiatric services with a $45 copay, and physical therapy and speech-language pathology services with a $10-$40 copay. Additionally, additional telehealth benefits are covered with a $0-$55 copay, and Opioid Treatment Program Services are covered with a $60-$100 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Humana Gold Plus H6622-021 (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services are covered, with some services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others not covered. Some other services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing services include hearing exams with a $45 copay, routine hearing exams with no copay for 1 visit every year, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay between $0 and $45, and routine eye exams have no copay. Eyewear, including contact lenses and eyeglasses (lenses and frames), has no copay, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include a $45 copay for Medicare dental services, and no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, oral and maxillofacial surgery, and prosthodontics, fixed. 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, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with 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 H6622-021 (HMO-POS) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have a coinsurance between 10% and 20%, while Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Humana Gold Plus H6622-021 (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $105, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $720. Therapeutic Radiological Services have a copay of up to $45 and coinsurance of at least 20%, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-021 (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, but none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is a $10 copay, and for days 21-100, the copay is $214.
Other Services See details
The Humana Gold Plus H6622-021 (HMO-POS) plan covers acupuncture with a $45 copay and meal benefits with no copay. Over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, 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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