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Humana Gold Plus H6622-047 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-047 (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 H6622-047 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-047 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Central and Northwest Mississippi. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-047 (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 H6622-047 (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 H6622-047 (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 $590.00 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 $5900.00 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 H6622-047 (HMO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, for a standard generic drug, you will pay a $47 copay. For preferred brand drugs, you will pay 40% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Humana Gold Plus H6622-047 (HMO) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays. It also covers primary care, preventive, hearing, vision, and dental services, with specific copays and coverage limits for each. The plan provides additional coverage for services such as ambulance, emergency care, home health, and skilled nursing, with some services requiring prior authorization or coinsurance.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered under the Humana Gold Plus H6622-047 (HMO) plan. For inpatient hospital acute and psychiatric services, you'll pay a $295 copay for days 1-7, and no copay for days 8-90; additional days are covered with no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services are covered. Outpatient Hospital Services have a copay between $0 and $350, Observation Services have a $295 copay, Ambulatory Surgical Center (ASC) Services have no copay, Individual and Group Sessions for Outpatient Substance Abuse have a copay between $30 and $50, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H6622-047 (HMO) plan, but requires prior authorization. You will have a $40 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H6622-047 (HMO) plan, including ground ambulance services with a $315 copay, and air ambulance services with 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Humana Gold Plus H6622-047 (HMO) plan. Emergency Services have a $125 copay with no coinsurance, Urgently Needed Services have a $55 copay with no coinsurance, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $125 copay with no coinsurance.
Primary Care See details
The Humana Gold Plus H6622-047 (HMO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a $25 copay, while physician specialist services have a $30 copay. The plan also covers mental health specialty services, psychiatric services, and opioid treatment program services, each with a copay of $30-$50, and physical therapy and speech-language pathology services with a $25 copay.
Preventive Services See details
Preventive Services include coverage for services like annual physical exams, with no copay. Additional preventive services, kidney disease education services, and other preventive services are covered, but may have copays; specific services such as health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $30 copay, routine hearing exams with no copay for one exam per year, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a copay between $399 and $699 for all types of prescription hearing aids, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Humana Gold Plus H6622-047 (HMO) plan covers vision services, including eye exams with a copay between $0 and $30, and eyewear with no copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a maximum benefit of $1750 per year. Medicare dental services require prior authorization and have a $30 copay. Other dental services include oral exams with no copay, dental x-rays with no copay, other diagnostic dental services with no copay, prophylaxis (cleaning) with no copay, and other preventive dental services with no copay. Restorative services and prosthodontics, removable have a 30-40% coinsurance and no copay, while prosthodontics, fixed has a 30-40% coinsurance and no copay. Fluoride treatment, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H6622-047 (HMO) plan, but require prior authorization. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 5% coinsurance, Prosthetics/Medical Supplies with 5% coinsurance, and Diabetic Equipment with a 10% coinsurance for Diabetic Supplies and a $10 copay for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Humana Gold Plus H6622-047 (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $55, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $325, Therapeutic Radiological Services have a copay up to $50, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-047 (HMO) plan 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 covered, but the plan does not cover the specific sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Humana Gold Plus H6622-047 (HMO) plan, requiring prior authorization. For days 1-20, there is a $10 copay, and for days 21-100, the copay is $214, while additional days beyond Medicare and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Gold Plus H6622-047 (HMO) plan covers acupuncture with a $30 copay and meal benefits with no copay, but does not cover 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, or Self-Directed Personal Assistance Services.
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