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Humana Gold Plus H6622-066 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-066 (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 H6622-066 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-066 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Southern 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 H6622-066 (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 H6622-066 (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 H6622-066 (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 $300.00 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 $8550.00 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 H6622-066 (HMO) plan has a $300 deductible for prescription drugs. Once you meet the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy you use. For example, in the initial coverage phase, you'll pay a $5 copay for preferred generic drugs at a standard or preferred mail pharmacy, and 35% coinsurance for preferred brand drugs. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Gold Plus H6622-066 (HMO) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays. This plan also covers primary care, specialist visits, and mental health services with copays, as well as preventive and hearing services. Vision and dental services are also covered, with no copays for routine eye exams and certain dental services. Additional benefits include ambulance services, emergency services, and home health services with no copays, and a $1500 annual maximum for dental services. This plan also covers home infusion, dialysis, and medical equipment with varying coinsurance or copays. It's important to note that some services, such as cardiac rehabilitation and certain other services, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $360 copay for days 1-7, and no copay for days 8-90, and for Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-7, and no copay for days 8-90. Additional Days for Inpatient Hospital-Acute is covered with no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $325, and observation services with a copay of $360. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have a copay between $35 and $85 for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H6622-066 (HMO) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H6622-066 (HMO) plan. Ground and air ambulance services each have a copay of $315, with no coinsurance, but 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 under the Humana Gold Plus H6622-066 (HMO) plan. Emergency Services have a $110 copay, Urgently Needed Services have a $45 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $110 copay.
Primary Care See details
The Humana Gold Plus H6622-066 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $20 and $35. Physician specialist services have a $35 copay, and mental health specialty services have a $35 copay. Additional telehealth benefits are covered with a copay between $0 and $45, and Opioid Treatment Program Services have a copay between $35 and $85. Physical therapy and speech-language pathology services have a copay between $20 and $35. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and an annual physical exam with no copay. Additional preventive services, including Fitness Benefit, have a copay.
Hearing Services See details
Humana Gold Plus H6622-066 (HMO) covers hearing exams with a $35 copay, routine hearing exams with no copay for one exam per year, and fitting/evaluation for hearing aids with no copay. The plan also covers prescription hearing aids with a copay between $499 and $799 for two hearing aids per year, but does not cover inner ear, outer ear, or over-the-ear hearing aids. OTC hearing aids are covered up to $50 every three months.
Vision Services See details
The Humana Gold Plus H6622-066 (HMO) plan covers vision services, including routine eye exams with no copay and eyewear with no copay, up to a combined maximum of $200 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H6622-066 (HMO) plan covers Medicare Dental Services with a $35 copay, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, and Prosthodontics, fixed with no copay. Fluoride Treatment, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered. The plan has a maximum benefit of $1500 per year for Other Dental Services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. 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 H6622-066 (HMO) plan, but require prior authorization. The coinsurance for this service is 20%.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment with 16% coinsurance, Prosthetics/Medical Supplies with 17% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay and 10% coinsurance, while Diabetic Therapeutic Shoes/Inserts have a $10 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 $105, and lab services with no copay. Radiological services are covered, including diagnostic radiological services with a copay up to $300, therapeutic radiological services with a copay up to $35 and 20% coinsurance, and outpatient X-Ray services with no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-066 (HMO) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-066 (HMO) does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Humana Gold Plus H6622-066 (HMO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Humana Gold Plus H6622-066 (HMO) plan covers acupuncture with a $35 copay, and also covers over-the-counter items with a maximum benefit of $50 every three months. The plan also covers a meal benefit with no copay. This plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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