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Humana Gold Plus H6622-028 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-028 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H6622-028 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-028 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-028 (HMO) 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 H6622-028 (HMO).
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 H6622-028 (HMO), 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 $615.00 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 $2400.00 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 H6622-028 (HMO) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply, which can be reduced to a $94 copay for a 3-month supply using preferred mail order. For higher-tier medications, you will pay coinsurance, which includes a 45% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs. This plan offers various cost-saving opportunities depending on your choice of pharmacy and mail-order services.
Additional Benefits
The Humana Gold Plus H6622-028 (HMO) plan offers affordable healthcare coverage with no copay or coinsurance for primary care visits and routine preventive services. For hospital care, inpatient stays require a $150 daily copay for the first six days and no copay thereafter, while emergency room visits carry a flat $150 copay. Specialist visits and Medicare-covered dental or hearing exams are also highly accessible with a low $10 copay and no coinsurance. Members benefit from generous dental, vision, and hearing coverage, featuring no copays for routine eye exams, cleanings, and over-the-counter hearing aids, plus a $150 annual allowance for eyewear. Other services like home health care and over-the-counter items are available with no copay, while durable medical equipment and dialysis require a standard 20% coinsurance. Skilled nursing facilities are covered with a $20 daily copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Humana Gold Plus H6622-028 (HMO) covers inpatient hospital services with no coinsurance, requiring a $150 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus H6622-028 (HMO) with no coinsurance for all services, offering no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $200 (including a $150 copay per stay for observation services), while outpatient substance abuse services have a copay of $25 to $35 per session.
Partial Hospitalization See details
Humana Gold Plus H6622-028 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-028 (HMO) covers ground ambulance services with a $335 copay and air ambulance services with a $630 copay, with no coinsurance required for either. While transportation services are technically listed as covered, some services are not covered in practice, including transportation to plan-approved or any health-related locations.
Emergency Services See details
Humana Gold Plus H6622-028 (HMO) covers emergency services with a $150 copay and no coinsurance, and urgently needed services with a $65 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-028 (HMO) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, and podiatry visits require a $10 copay and no coinsurance. Mental health, psychiatric, telehealth, and opioid treatment services feature copays ranging from no copay up to $65 with no coinsurance, whereas chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Humana Gold Plus H6622-028 (HMO) with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, glaucoma screenings, and memory fitness. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, telemonitoring, and counseling.
Hearing Services See details
Hearing services are covered by Humana Gold Plus H6622-028 (HMO), featuring a $10 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams, fittings, and OTC hearing aids. Prescription hearing aids are partially covered with a copay of $699 to $999 and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-028 (HMO) partially covers vision services with no copays, no coinsurance, and no deductibles, though prior authorization and referrals are required. Covered benefits include one routine eye exam and up to $150 yearly for contact lenses or eyeglasses, while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H6622-028 (HMO), featuring a $10 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-028 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and other drugs, have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus H6622-028 (HMO) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Humana Gold Plus H6622-028 (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies and therapeutic shoes are also covered, featuring 10% to 20% coinsurance and copays ranging from no copay up to $10, with prior authorization required.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-028 (HMO) covers diagnostic and radiological services, though prior authorization and referrals are required. Members pay no copay for lab services and outpatient X-rays, a $0 to $65 copay with no coinsurance for diagnostic procedures, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Humana Gold Plus H6622-028 (HMO) covers home health services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-028 (HMO) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization and a referral are required. However, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-028 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-028 (HMO) offers other services including acupuncture for a $10 copay and no coinsurance, as well as over-the-counter items and chronic illness meals with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and some services, including certain CMS OTC list drugs, are not covered.
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