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Humana Gold Plus H6622-056 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-056 (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 H6622-056 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-056 (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 H6622-056 (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 H6622-056 (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 H6622-056 (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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $925.00 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 H6622-056 (HMO) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, there is no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. If you use standard mail order, Tier 1 drugs have a $10 copay for a 1-month supply ($30 for 3 months) and Tier 2 drugs have a $20 copay ($60 for 3 months). Tier 3 (Preferred Brand) drugs cost a $47 copay for a 1-month supply across all options, with 3-month supplies costing $141, except through preferred mail order which lowers the cost to a $94 copay. Tier 4 (Non-Preferred) drugs require a 50% coinsurance for all fulfillment methods for both 1-month and 3-month supplies. Specialty drugs in Tier 5 require a 33% coinsurance for a 1-month supply, regardless of whether you use standard pharmacies, preferred mail order, or standard mail order.
Additional Benefits
The Humana Gold Plus H6622-056 (HMO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for inpatient hospital stays, primary care, specialist visits, and home health services. Outpatient hospital services carry a copay ranging from no copay to $35, while emergency room visits require a $150 copay and urgent care services have a $65 copay. Routine preventive care, annual physicals, and lab services are also fully covered with no copay or coinsurance. For supplemental care, members benefit from routine vision, dental preventive care, and routine hearing exams with no copay and no coinsurance, including up to $2,500 in dental coverage. Prescription hearing aids require copays between $599 and $899, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay. Additionally, the plan covers up to 30 one-way transportation trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
Humana Gold Plus H6622-056 (HMO) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization and referrals are required. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-056 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center, outpatient blood, and observation services with no copays. Outpatient hospital services have a copay ranging from $0 to $35, while outpatient substance abuse sessions require a copay of $25 to $35.
Partial Hospitalization See details
Partial hospitalization services are covered under the Humana Gold Plus H6622-056 (HMO) plan with a $35 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-056 (HMO) covers ambulance services with no coinsurance, requiring a $335 copay for ground transport and a $630 copay for air transport. Transportation services are partially covered with no copay or coinsurance for up to 30 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
Humana Gold Plus H6622-056 (HMO) covers emergency services with a $150 copay and no coinsurance, and urgently needed services with a $65 copay and no coinsurance. Worldwide emergency coverage, urgent coverage, and emergency transportation are also covered with a $150 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-056 (HMO) covers primary care, specialist, therapy, and podiatry services with no copay and no coinsurance, while chiropractic services are not covered. Mental health, psychiatric, and opioid treatment services require no coinsurance and have copays ranging from $25 to $35, and telehealth benefits feature a copay of $0 to $65 with no coinsurance.
Preventive Services See details
Preventive services are covered by Humana Gold Plus H6622-056 (HMO) with no copay and no coinsurance for annual physical exams, kidney disease education, and memory fitness. However, additional preventive benefits are only partially covered, with no coverage for services such as health education, weight management programs, alternative therapies, and in-home safety assessments.
Hearing Services See details
Hearing services are covered by Humana Gold Plus H6622-056 (HMO), offering routine hearing exams, fitting evaluations, and over-the-counter hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $599 to $899 for up to two devices per year, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-056 (HMO) vision services are partially covered, featuring one routine eye exam and one pair of eyeglasses or contact lenses per year with no copay and no coinsurance up to a $300 maximum limit. Other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-056 (HMO) provides partially covered dental services up to a $2,500 annual limit, featuring no copay and no coinsurance for preventive care, endodontics, periodontics, and oral surgery, but requiring 30% to 40% coinsurance and no copay for restorative and prosthodontic services. Fluoride treatments, implants, maxillofacial prosthetics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Humana Gold Plus H6622-056 (HMO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Associated Medicare Part B chemotherapy and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H6622-056 (HMO) plan with no copay and a 20% coinsurance. Both prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus H6622-056 (HMO), with durable medical equipment and prosthetics requiring 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 H6622-056 (HMO) covers diagnostic and radiological services, with prior authorization and referrals required. Diagnostic tests and procedures have no coinsurance and a copay ranging from $0 to $65, while lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H6622-056 (HMO) with no copay and no coinsurance. To access this benefit, both a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under Humana Gold Plus H6622-056 (HMO). While the plan technically offers these services with no copayment and no coinsurance, all specific sub-services—including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-056 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a copay of $20 for days 1 to 20 and $218 for days 21 to 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Humana Gold Plus H6622-056 (HMO) with no copay and no coinsurance for acupuncture, chronic illness meal benefits, and over-the-counter items. Prior authorization is required for the meal benefit and acupuncture, which is limited to 20 treatments per year, while other supplemental services are not covered.
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