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Humana Gold Plus H6622-025 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-025 (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 H6622-025 (HMO-POS) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-025 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Western North Carolina 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 H6622-025 (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 H6622-025 (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 H6622-025 (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 $350.00 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 H6622-025 (HMO-POS) plan has a $350 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $5 copay for preferred generic drugs at a standard pharmacy, and 50% coinsurance for preferred brand drugs. During the initial coverage phase, you will pay these costs until your total drug costs reach $2000. Once you reach $2000 in out-of-pocket drug costs, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The Humana Gold Plus H6622-025 (HMO-POS) plan offers comprehensive coverage, including no copays for primary care, preventive services, home health, and many outpatient services. This plan also includes coverage for inpatient hospital stays, emergency services, and a range of therapies, with varying copays depending on the service. Dental, vision, and hearing services are included, with no copays for routine exams and eyewear, and a $1,000 annual maximum for dental.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you'll pay a $399 copay for days 1-6, and no copay for days 7-90; additional days have no copay. Inpatient Hospital Psychiatric has a $399 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $450, Observation Services with a $399 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $45 and $100 for both individual and group sessions, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H6622-025 (HMO-POS) plan, but requires prior authorization. You will pay an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H6622-025 (HMO-POS) plan. Ground and Air Ambulance Services have a $315 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services have a $110 copay with no coinsurance, and Urgently Needed Services have a $45 copay with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $110 copay with no coinsurance.
Primary Care See details
The Humana Gold Plus H6622-025 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy with a $25 copay, physician specialist services with a $45 copay, mental health specialty services with a $45 copay, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a copay ranging from $0 to $45, and opioid treatment program services with a copay ranging from $45 to $100. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered zero dollar services, are covered. Annual physical exams have no copay, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits have no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services with the Humana Gold Plus H6622-025 (HMO-POS) plan includes hearing exams with a $45 copay. Routine hearing exams are covered with no copay, and fitting/evaluation for hearing aids have no copay. Prescription hearing aids (all types) have a copay between $699 and $999, while prescription hearing aids (inner ear, outer ear, and over the ear) are not covered. OTC hearing aids are covered up to $50 every three months.
Vision Services See details
The Humana Gold Plus H6622-025 (HMO-POS) plan covers vision services, including routine eye exams with a copay between $0 and $45, and eyewear with a $0 copay. Contact lenses and eyeglasses (lenses and frames) are covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H6622-025 (HMO-POS) plan covers dental services with a $1,000 annual maximum, including oral exams, dental X-rays, other diagnostic services, prophylaxis (cleaning), and other preventive services with no copay. Fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and 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%.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H6622-025 (HMO-POS) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, and medical supplies, is covered under this plan. Durable Medical Equipment has a 20% coinsurance and requires authorization, while durable medical equipment for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance. Diabetic supplies have a 10% coinsurance and no copay, while diabetic therapeutic shoes/inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $120, and lab services with no copay. Radiological Services include coverage for diagnostic radiological services with a maximum copay of $325, therapeutic radiological services with a coinsurance of at least 20% and a copay of at least $45, and outpatient X-Ray services with no copay.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H6622-025 (HMO-POS) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Humana Gold Plus H6622-025 (HMO-POS) plan covers acupuncture with a $45 copay and a limit of 20 treatments per year. Over-the-counter items are covered with a $50 maximum benefit every three months, and the plan offers a meal benefit with no copay for chronic illnesses. Several other services are not covered.
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