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Humana Gold Plus H6622-032 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-032 (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 H6622-032 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-032 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Oklahoma. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-032 (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 H6622-032 (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 H6622-032 (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 $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 $4300.00 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 H6622-032 (HMO) plan has a $250 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you'll pay an $8 copay for preferred generic drugs at preferred and mail order pharmacies, and a $20 copay at standard pharmacies. You will pay 40% coinsurance for preferred brand drugs, and 30% coinsurance for non-preferred drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Humana Gold Plus H6622-032 (HMO) plan offers a wide range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a $125 copay. The plan also provides coverage for primary care visits with no copay, preventive services with no copay, and hearing and vision services with specific copays and coverage limits. This plan includes dental coverage with a $1,000 annual maximum, home health services with no copay, and skilled nursing facility services with copays for specific days. Additionally, the plan covers ambulance services, home infusion, dialysis services, and medical equipment with either copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-7, the copay is $290, and for days 8-90, there is no copay. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay ranging from $0 to $275, observation services with a $290 copay, Ambulatory Surgical Center (ASC) services with no copay, outpatient substance abuse services with a copay between $35 and $40 for individual or group sessions, and outpatient blood services with no copay. Outpatient blood services also have a three-pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H6622-032 (HMO) plan, and requires prior authorization. The copay for this benefit is $35.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $315 copay for both ground and air ambulance services, and no coinsurance. 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. Emergency Services and Worldwide Emergency Coverage have a $125 copay, and Urgently Needed Services has a $55 copay; all have no coinsurance.
Primary Care See details
The Humana Gold Plus H6622-032 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $35 copay, physician specialist services with a $40 copay, and mental health specialty services with a $30 copay for individual and group sessions. The plan also covers physical therapy and speech-language pathology services with a $35 copay, additional telehealth benefits with a copay between $0 and $55, and opioid treatment program services with a copay between $35 and $40. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive Services include Medicare-covered preventive services with no copay, as well as an annual physical exam with no copay. Additional preventive services are covered, including fitness benefits, with a copay. Other covered services include kidney disease education services with no copay, and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Humana Gold Plus H6622-032 (HMO) covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) have a copay between $699 and $999, but prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include routine eye exams with a copay of $0, and eyewear. Eyewear includes contact lenses and eyeglasses (lenses and frames) with a $0 copay, and a combined maximum plan benefit coverage of $150 every year, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a $1,000 annual maximum. Medicare Dental Services have a $40 copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services are covered with no copay. Fluoride treatment, prosthodontics (removable), maxillofacial prosthetics, implant services, and orthodontics are not covered. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (fixed), and oral and maxillofacial surgery are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Humana Gold Plus H6622-032 (HMO) plan, with prior authorization required. 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 H6622-032 (HMO) plan. There is a coinsurance of 20% for these services, and prior authorization is required.
Medical Equipment See details
The Humana Gold Plus H6622-032 (HMO) plan covers Medical Equipment, including Durable Medical Equipment (DME) with 10% coinsurance and Prosthetics/Medical Supplies with 10% coinsurance. Diabetic Equipment is covered, with specific costs detailed in the plan documents; Diabetic Supplies have a 5% coinsurance and no copay, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Humana Gold Plus H6622-032 (HMO) plan. Diagnostic Procedures/Tests have a coinsurance of at most 20% and a copay of up to $80, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $325, and Therapeutic Radiological Services have a copay of up to $40. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H6622-032 (HMO) 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 not covered by the Humana Gold Plus H6622-032 (HMO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H6622-032 (HMO) plan, but require prior authorization. For days 1-20, there is a $10 copay, and for days 21-100, there is a $214 copay; there is no coinsurance.
Other Services See details
Other Services includes acupuncture, which has a $40 copay, and a meal benefit 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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