A non-government entity
Humana Gold Plus H6622-057 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-057 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus H6622-057 (HMO-POS) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-057 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Charlotte Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-057 (HMO-POS) 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 H6622-057 (HMO-POS).
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 H6622-057 (HMO-POS), 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 $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 $9250.00 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 H6622-057 (HMO-POS)
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 H6622-057 (HMO-POS) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and preferred mail-order services. Tier 2 generic drugs are also highly affordable, with a $5 copay for a 1-month supply and no copay for a 3-month supply when filled through preferred mail order. For Tier 3 preferred brand drugs, the cost is a $47 copay for a 1-month supply, or $131 for a 3-month supply through preferred mail order. Tier 4 non-preferred drugs require a 43% coinsurance for both 1-month and 3-month supplies across all pharmacy options. Finally, Tier 5 specialty drugs have a 25% coinsurance for a 1-month supply at standard pharmacies and mail-order services.
Additional Benefits
The Humana Gold Plus H6622-057 (HMO-POS) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $40 copay, while inpatient hospital stays have a $475 daily copay for the first five days and no copay for subsequent days. Emergency care is covered with a $115 copay, which is waived if you are admitted within 24 hours, and urgent care is available for a $40 copay. For supplemental benefits, the plan features routine vision, hearing, and dental care with no copay and no coinsurance, subject to specific plan maximums. Diagnostic lab work and outpatient X-rays also require no copay, while durable medical equipment and dialysis services carry a 20% coinsurance with no copay. Additionally, skilled nursing facility stays require no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Humana Gold Plus H6622-057 (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $475 daily copay for days 1 to 5, and no copay for days 6 and beyond. Inpatient psychiatric stays are also covered with no coinsurance and a $475 daily copay for days 1 to 4 (no copay for days 5 to 90), but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-057 (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $450 ($475 per stay for observation services), while individual and group outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Humana Gold Plus H6622-057 (HMO-POS) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-057 (HMO-POS) covers ground and air ambulance services with a $335 copay and no coinsurance, with prior authorization required. For transportation services, some services are covered but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H6622-057 (HMO-POS) 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 care is available for 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 H6622-057 (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Physical, occupational, speech, psychiatric, and mental health services are covered with copays ranging from $25 to $35 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered under the Humana Gold Plus H6622-057 (HMO-POS) plan with no copay and no coinsurance, which includes annual physical exams, kidney disease education, diabetes self-management training, and glaucoma screenings. However, additional preventive services such as fitness benefits, health education, nutritional counseling, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H6622-057 (HMO-POS) with no deductibles and no coinsurance. Medicare-covered exams require a $40 copay, while routine exams and fitting evaluations have no copay. Covered prescription hearing aids carry a copay of $0 to $599 with a limit of 2 every three years, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-057 (HMO-POS) partially covers vision services with no deductibles and no coinsurance, providing routine eye exams, eyeglasses, and contact lenses with no copay, up to a $300 annual limit. Other eye exam services, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
Humana Gold Plus H6622-057 (HMO-POS) offers partially covered dental services up to a $1,000 annual maximum, featuring no copay and no coinsurance for covered preventive and comprehensive care, while Medicare-covered dental has a $40 copay and no coinsurance. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-057 (HMO-POS) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs are subject to 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Humana Gold Plus H6622-057 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H6622-057 (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. DME, prosthetics, and medical supplies require a 20% coinsurance and no copay, while diabetic supplies carry a 10% to 20% coinsurance with no copay. Diabetic therapeutic shoes and inserts have a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-057 (HMO-POS) diagnostic and radiological services are covered with no coinsurance for diagnostic services, alongside no copays for lab services and outpatient X-rays. Outpatient diagnostic procedures and tests carry a copay of $0 to $120, while therapeutic radiological services require a 20% coinsurance and a minimum $40 copay.
Home Health Services See details
Humana Gold Plus H6622-057 (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under Humana Gold Plus H6622-057 (HMO-POS) with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-057 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Other services are partially covered by Humana Gold Plus H6622-057 (HMO-POS), which offers acupuncture with a $40 copay, no coinsurance, and prior authorization for up to 20 treatments per year. Over-the-counter (OTC) items and meal benefits are not covered under this plan.
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