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Humana Gold Plus H6622-037 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-037 (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 H6622-037 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-037 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Greater Philadelphia. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-037 (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 H6622-037 (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 H6622-037 (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 $7800.00 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 H6622-037 (HMO) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for 1-month and 3-month supplies at standard pharmacies or through preferred mail order. Tier 2 generic drugs are also budget-friendly, costing $5 for a 1-month supply at standard pharmacies and offering no copay for a 3-month supply when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply, which costs $141 for a 3-month standard supply or drops to $131 via preferred mail order. For higher-tier medications, Tier 4 non-preferred drugs require a 47% coinsurance, while Tier 5 specialty drugs carry a 25% coinsurance for a 1-month supply. These structured copays and coinsurance rates allow you to easily plan your healthcare budget with this Humana Medicare Advantage plan.
Additional Benefits
The Humana Gold Plus H6622-037 (HMO) plan features robust medical coverage with no copay for primary care visits, annual physical exams, and home health services. Specialist visits require a $25 copay, while inpatient hospital stays carry a $330 daily copay for the first eight days of acute care with no copay for subsequent days. Outpatient hospital services range from no copay up to a $600 copay, and diagnostic lab services and X-rays are available with no copay. This plan also includes valuable supplemental benefits, such as dental coverage up to a $3,000 annual limit with no copay for preventive care and a 30% to 40% coinsurance for restorative services. Vision and hearing benefits offer routine exams with no copay, alongside a $300 annual eyewear allowance and no copay for over-the-counter hearing aids. Additionally, members can access up to 24 one-way transportation trips to plan-approved locations, over-the-counter items, and meal benefits with no copay.
Inpatient Hospital See details
Humana Gold Plus H6622-037 (HMO) offers partially covered inpatient hospital services with no coinsurance, requiring a $330 daily copay for days 1-8 of acute stays and a $260 daily copay for days 1-8 of psychiatric stays, with no copay for subsequent covered days. Prior authorization is required, and hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-037 (HMO) covers outpatient services with no coinsurance, featuring a $0 to $600 copay for outpatient hospital services and a $330 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services have a $30 to $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Humana Gold Plus H6622-037 (HMO) with a $35.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-037 (HMO) covers ambulance services with a $335 copay and no coinsurance for both ground and air transport, subject to prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
Humana Gold Plus H6622-037 (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 require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-037 (HMO) offers primary care physician services with no copay and no coinsurance, alongside telehealth benefits with a $0 to $40 copay and no coinsurance. Specialist visits require a $25 copay, mental health and psychiatric sessions have a $30 copay, and physical, occupational, and speech therapies range from a $20 to $30 copay, all with no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H6622-037 (HMO) covers key preventive services, including annual physical exams, kidney disease education, and diabetes training, with no copay and no coinsurance. Additional preventive services are only partially covered, as the plan includes a memory fitness benefit but excludes health education, weight management, alternative therapies, and in-home safety assessments.
Hearing Services See details
Hearing services under Humana Gold Plus H6622-037 (HMO) feature no coinsurance across all benefits, with a $25 copay for Medicare-covered exams, no copay for annual routine exams and fitting evaluations, and no copay for OTC hearing aids. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $199.00 to $499.00 for up to two devices per year, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-037 (HMO) partially covers vision services with no deductible, no coinsurance, and no copays for covered benefits, though prior authorization is required. Eligible services include one annual routine eye exam and a $300 yearly allowance for contact lenses or eyeglasses, but other eye exams, separate eyeglass lenses or frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-037 (HMO) offers partially covered dental services up to a $3,000 annual limit, featuring a $25 copay and no coinsurance for Medicare-covered dental. Preventive care, endodontics, periodontics, and oral surgery are available with no copay and no coinsurance, while restorative and removable prosthodontics require no copay and 30% to 40% coinsurance; however, fluoride, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-037 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, such as chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Humana Gold Plus H6622-037 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment benefits under the Humana Gold Plus H6622-037 (HMO) cover 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
Humana Gold Plus H6622-037 (HMO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay. Diagnostic procedures and tests have a copay of $0 to $105 with no coinsurance, diagnostic radiological services have a copay starting at $0, and therapeutic radiological services require a minimum 20% coinsurance and a copay starting at $30.
Home Health Services See details
Humana Gold Plus H6622-037 (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 H6622-037 (HMO) with no coinsurance and require prior authorization, though some services are not covered, including cardiac rehabilitation and intensive cardiac rehabilitation (both requiring a $25 copay), as well as pulmonary rehabilitation and SET for PAD services (both requiring a $10 copay).
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-037 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not needed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-037 (HMO) covers acupuncture with a $20 copay and no coinsurance, as well as over-the-counter items and meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meals, and certain other miscellaneous services are not covered.
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