A non-government entity
Humana Gold Plus H6622-035 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-035 (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 H6622-035 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-035 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select counties in South Central Pennsylvania. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-035 (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 H6622-035 (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 H6622-035 (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 $1.00. 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 $8300.00 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:
Sign up for Humana Gold Plus H6622-035 (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Humana Gold Plus H6622-035 (HMO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is no copay for one-month or three-month fills at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, costing as little as a $5 copay for a one-month supply, or no copay for a three-month supply when using preferred mail order. For brand-name and specialty medications, costs vary depending on the drug tier. Tier 3 preferred brand drugs carry a $47 copay for a one-month supply across standard pharmacies and mail order options. Tier 4 non-preferred drugs require 48% coinsurance, while Tier 5 specialty drugs require 25% coinsurance for a one-month supply.
Additional Benefits
The Humana Gold Plus H6622-035 (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits and annual preventive services. Specialist visits carry a copay of $20 to $35, while inpatient hospital stays require a $290 daily copay for the first seven days and no copay thereafter. Emergency room visits are covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Supplemental benefits include routine dental, vision, and hearing exams with no copay, alongside a $500 eyewear allowance and a $2,000 annual limit for covered dental services. The plan also features up to 24 free one-way transportation trips per year and home health services with no copay. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Humana Gold Plus H6622-035 (HMO) covers inpatient hospital services with no coinsurance, requiring a $290 daily copay for days 1 through 7 and no copay for days 8 and beyond. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-035 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services at no copay. Outpatient hospital services have a $0 to $325 copay, observation services have a $290 copay per stay, and outpatient substance abuse sessions have a $35 copay, all with no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H6622-035 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-035 (HMO) covers ambulance services with a $335 copay and no coinsurance for both ground and air transport. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Humana Gold Plus H6622-035 (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by Humana Gold Plus H6622-035 (HMO), featuring no copay and no coinsurance for primary care visits, and copays between $20 and $35 with no coinsurance for specialists, mental health, and physical therapy. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus H6622-035 (HMO) covers preventive services, such as annual physical exams, kidney disease education, glaucoma screenings, and memory fitness, with no copay and no coinsurance. However, this benefit is only partially covered, as health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are covered by Humana Gold Plus H6622-035 (HMO), featuring no copay or coinsurance for routine hearing exams, fitting evaluations, and OTC hearing aids. Medicare-covered exams require a $35 copay and no coinsurance, while prescription hearing aids are partially covered with a $0 to $299 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
Humana Gold Plus H6622-035 (HMO) offers partially covered vision services with no coinsurance and a $0 to $35 copay for eye exams, featuring no copay for an annual routine exam. Eyewear is also covered with no copay or coinsurance up to a $500 annual limit, though other eye exam services, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-035 (HMO) partially covers dental services, featuring Medicare-covered dental with a $35 copay and no coinsurance, and other covered dental services with no copay and no coinsurance up to a $2,000 annual maximum. Excluded services that are not covered include fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Humana Gold Plus H6622-035 (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy may apply. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H6622-035 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H6622-035 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus H6622-035 (HMO), with prior authorization required for these services. Lab services, outpatient X-rays, and diagnostic radiological services feature no copay and no coinsurance, while other diagnostic procedures carry a copay of $0 to $105, and therapeutic radiological services require a minimum $35 copay and 20% coinsurance.
Home Health Services See details
Humana Gold Plus H6622-035 (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Humana Gold Plus H6622-035 (HMO) with no copay, no coinsurance, and prior authorization required. However, some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-035 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day inpatient hospital stay requirement, though prior authorization is required. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by the Humana Gold Plus H6622-035 (HMO), excluding Other 1, Other 2, and Other 3 services. Covered benefits include acupuncture with a $35 copay and no coinsurance, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved