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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 2025, 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 2025.
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 $5.00. 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 $1200.00 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 has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, you may pay a $5 copay for a preferred generic drug at a standard or preferred mail pharmacy, or 50% coinsurance for a preferred brand drug. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The Humana Gold Plus H6622-056 (HMO) plan offers comprehensive coverage with a focus on outpatient and preventive services. Many services have no copay, including inpatient hospital stays, outpatient blood services, and primary care visits. The plan includes coverage for emergency services, hearing exams, vision services, and dental services, with varying cost-sharing. There is also coverage for home health, medical equipment, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with no copay. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric 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 and Outpatient Substance Abuse Services have a copay between $0 and $30, while Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H6622-056 (HMO) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Medicare-covered ground ambulance services have a $315 copay, and Medicare-covered air ambulance services have a $630 copay, with 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 by the Humana Gold Plus H6622-056 (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services have a $10 copay; all have no coinsurance.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, Mental Health Specialty Services, and Physical Therapy and Speech-Language Pathology Services have no copay. Chiropractic Services, Occupational Therapy Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Additional Telehealth Benefits, and Opioid Treatment Program Services have a copay that varies from $0 to $30. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams with no copay, and additional preventive services and kidney disease education services with no copay. Other preventive services include no copay for glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing exams, including routine hearing exams and fitting/evaluation for hearing aids, are covered with no copay. Prescription Hearing Aids are partially covered, with a copay between $599 and $899 for all types, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC Hearing Aids are covered up to $100 every three months.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay. Eyewear has no copay, and a combined maximum plan benefit coverage of $300 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H6622-056 (HMO) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, all with no copay. Prosthodontics (removable and fixed) and prosthodontics, fixed each have a 30% coinsurance. Fluoride treatment, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. There is a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% depending on the drug.
Dialysis Services See details
Dialysis Services are covered by the Humana Gold Plus H6622-056 (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 15% coinsurance, while Prosthetics/Medical Supplies have a 20% coinsurance. Diabetic Supplies have a 10-20% coinsurance with no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance with a copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures and lab services with a copay of $0 to $30, and outpatient X-ray services with no copay. Therapeutic Radiological Services have a coinsurance of 20%, while diagnostic radiological services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-056 (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 with prior authorization and a doctor referral, but none of the sub-services are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but require prior authorization and a doctor's referral. For days 1-20, the copay is $20, and for days 21-100, the copay is $125; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Gold Plus H6622-056 (HMO) plan covers acupuncture with no copay, but requires prior authorization and is limited to 20 treatments per year. Over-the-counter items are covered with a maximum benefit of $100 every three months, including nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay for chronic illnesses, but some other services are not covered.
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