A non-government entity
Humana Gold Plus H6622-063 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-063 (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 H6622-063 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-063 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in New Jersey. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-063 (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 H6622-063 (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 H6622-063 (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 $3.00. 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 $225.00 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 $8850.00 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 H6622-063 (HMO)
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 H6622-063 (HMO) plan has a $225 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, a standard generic drug has a $5 copay at a preferred pharmacy, and a $20 copay at a standard mail pharmacy. For preferred brand drugs, you will pay 37% coinsurance, and for non-preferred drugs, you will pay 30% 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 H6622-063 (HMO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with copays ranging from $20 to $775, and emergency services with a $110 copay. The plan also includes coverage for primary care, preventive services, hearing, vision, and dental services, often with no copay. Additional benefits include home health services, skilled nursing facility care, and medical equipment, with varying copays and coinsurance amounts. The plan also covers acupuncture, over-the-counter items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute with a \$345 copay for days 1-7, and no copay for days 8-90, and Inpatient Hospital Psychiatric with a \$260 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $20 and $775, Observation Services with a $345 copay, Ambulatory Surgical Center (ASC) Services with a $270 copay, Outpatient Substance Abuse Services with a copay between $20 and $100 for both individual and group sessions, and Outpatient Blood Services with no copay. All services require prior authorization.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H6622-063 (HMO) plan. The plan has a $55 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Humana Gold Plus H6622-063 (HMO) plan. Ground and Air Ambulance services have a $315 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, have a copay. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services have a $45 copay.
Primary Care See details
The Humana Gold Plus H6622-063 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a $20 copay. The plan also covers physician specialist services with a $20 copay, mental health specialty services with a $20 copay, and physical therapy and speech-language pathology services with a $20 copay.
Preventive Services See details
The Humana Gold Plus H6622-063 (HMO) plan covers preventive services, including an annual physical exam with no copay. Additionally, the plan covers other preventive services like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing services include hearing exams with a $20 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with all types of prescription hearing aids having a copay between $699 and $999, and inner ear, outer ear, and over the ear hearing aids not covered. OTC hearing aids are covered with a maximum benefit of $20 per month.
Vision Services See details
Vision services include coverage for eye exams and eyewear, with some services requiring prior authorization. Routine eye exams have no copay, while other eye exams have a copay between $0 and $20. Eyewear, including contact lenses and eyeglasses, have no copay, but there is a combined maximum plan benefit of $200 per year.
Dental Services See details
The Humana Gold Plus H6622-063 (HMO) plan covers dental services, including oral exams with no coinsurance and a $20 copay, Dental X-Rays and Other Diagnostic Dental Services with no coinsurance, and Prophylaxis (Cleaning) with no coinsurance. Restorative Services and Periodontics have a $25 copay. Fluoride Treatment, Endodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, 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%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H6622-063 (HMO) plan, with a coinsurance of 20%. Prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics, Medical Supplies, and Diabetic Equipment, are covered under the Humana Gold Plus H6622-063 (HMO) plan. Durable Medical Equipment has a 7% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 7% coinsurance. Medical Supplies have a 7% coinsurance. Diabetic Supplies have a coinsurance between 7% and 10%, and no copay. Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $80, and lab services with no copay. Outpatient X-ray services have no copay, and diagnostic radiological services have a copay up to $325 with a minimum of $20. Therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-063 (HMO) plan with no copay and no coinsurance, although additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. A copay applies for the covered services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Humana Gold Plus H6622-063 (HMO) plan covers acupuncture with no copay, and up to 25 treatments per year, as well as a monthly allowance of $20 for over-the-counter items, and a meal benefit with no copay for chronic illnesses. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and more are not covered.
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