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Humana Gold Plus H6622-061 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-061 (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 H6622-061 (HMO-POS) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-061 (HMO-POS) is a HMO-POS plan offered by Humana Inc. available for enrollment in 2025 to people living in Wilmington. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-061 (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 H6622-061 (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 H6622-061 (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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $350.00 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:
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Drug Coverage
The Humana Gold Plus H6622-061 (HMO-POS) plan has an annual prescription drug deductible of $350. You can save on coverage with Tier 1 preferred generic drugs, which feature no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also budget-friendly, costing a $5 copay for a 1-month supply at standard pharmacies, or no copay for a 3-month supply when filled through preferred mail order. For brand-name and specialty medications, Tier 3 preferred brand drugs require a $47 copay for a 1-month supply. Tier 4 non-preferred drugs carry a 48% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance. Utilizing preferred mail order services can help minimize your out-of-pocket costs for multi-month drug supplies under this plan.
Additional Benefits
The Humana Gold Plus H6622-061 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $375 for the first several days and no copay thereafter, with no coinsurance required. Emergency room visits carry a $115 copay, while specialist visits require a $35 copay. This plan also includes strong supplemental benefits, featuring no copay for preventive and comprehensive dental care up to a $1,500 annual limit, as well as no copay for routine vision and hearing exams. Prescription hearing aids are covered with copays ranging from $0 to $599, and eyewear is covered up to a $350 annual limit. For specialized needs, durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
Humana Gold Plus H6622-061 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, though prior authorization is required. For acute stays, you will pay a $375 daily copay for days 1 through 7 and no copay for days 8 and beyond, while psychiatric stays require a $375 daily copay for days 1 through 5 and no copay for days 6 through 90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-061 (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $450, outpatient substance abuse sessions require a $35 copay, and observation services have a $375 copay per stay, all with no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H6622-061 (HMO-POS) covers partial hospitalization with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-061 (HMO-POS) covers Medicare-covered ground and air ambulance services with a $335 copay and no coinsurance, though prior authorization is required. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H6622-061 (HMO-POS) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay with 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 H6622-061 (HMO-POS) covers primary care visits with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $25 copay and no coinsurance, though podiatry is not covered and chiropractic services are only partially covered because routine and other chiropractic care are excluded.
Preventive Services See details
Humana Gold Plus H6622-061 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and disease screenings. However, several supplemental benefits are not covered, including health education, weight management programs, in-home safety assessments, and nutritional counseling.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H6622-061 (HMO-POS) with no coinsurance, requiring a $35 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. While prescription hearing aids are covered with a copay of $0 to $599 for up to two aids every three years, OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-061 (HMO-POS) vision services are partially covered, featuring no deductible, no coinsurance, and a $0 to $35 copay for eye exams, plus no copay or coinsurance for eyewear up to a $350 annual limit. Covered benefits include one routine eye exam and one pair of eyeglasses or contact lenses per year, while other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-061 (HMO-POS) offers partially covered dental services with a $35 copay and no coinsurance for Medicare-covered care, and no copay and no coinsurance for preventive and comprehensive services up to a $1,500 annual maximum. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-061 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H6622-061 (HMO-POS) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus H6622-061 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Covered diabetic supplies carry a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts have a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-061 (HMO-POS) covers diagnostic and radiological services with prior authorization required. Lab services and outpatient X-rays feature no copay, diagnostic tests range from a $0 to $120 copay with no coinsurance, and therapeutic radiology requires a minimum $40 copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H6622-061 (HMO-POS) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-061 (HMO-POS) provides cardiac rehabilitation services with no copay and no coinsurance, meaning some services are covered, though standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-061 (HMO-POS) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. While a prior three-day hospital stay is not required, prior authorization is necessary, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Humana Gold Plus H6622-061 (HMO-POS) partially covers other services, offering acupuncture for up to 20 treatments per year with a $35 copay and no coinsurance, alongside a chronic illness meal benefit with no copay and no coinsurance. Prior authorization is required for both covered benefits, and over-the-counter (OTC) items are not covered.
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