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Humana Gold Plus H6622-075 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-075 (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 H6622-075 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-075 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Carson City and Washoe counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-075 (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 H6622-075 (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 H6622-075 (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 $1.00. 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 $3525.00 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 H6622-075 (HMO) Medicare plan features a $0 drug deductible, meaning your prescription drug coverage starts immediately with no upfront deductible costs. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for both 1-month and 3-month supplies filled at standard pharmacies or through preferred mail order. If you utilize standard mail order, Tier 1 and Tier 2 drugs carry a 1-month copay of $10 and $20 respectively. For brand-name and specialty medications, the plan transitions to copays and coinsurance. Tier 3 preferred brand drugs cost a $47 copay for a 1-month supply across all options, though a 3-month preferred mail order supply offers savings at a $94 copay. Tier 4 non-preferred drugs require a 48% coinsurance, while Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply.
Additional Benefits
The Humana Gold Plus H6622-075 (HMO) plan offers comprehensive medical coverage with many essential services featuring no copay and no coinsurance. You will pay no copay for primary care doctor visits, preventive care, and home health services, while specialist visits require a $30 copay. Inpatient hospital stays require a $375 daily copay for days one through five, followed by no copay for days six through 90. Supplemental benefits include dental coverage up to a $2,000 annual limit, offering no copay for preventive care and a $25 copay for restorative services. Routine vision and hearing exams also feature no copay, alongside a $250 annual allowance for glasses or contact lenses. For urgent and emergency needs, you will pay a $65 copay for urgent care and a $150 copay for emergency room visits, which is waived if you are admitted within 24 hours.
Inpatient Hospital See details
Humana Gold Plus H6622-075 (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $375 daily copay for days 1 to 5 and no copay for days 6 to 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-075 (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which both feature no copay. Outpatient hospital services require a copay of $0 to $375 (with a $375 copay per observation stay) and no coinsurance, while outpatient substance abuse sessions have a copay of $25 to $35 and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Humana Gold Plus H6622-075 (HMO) plan with a $35.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-075 (HMO) covers ground ambulance services with a $335 copay and air ambulance services with a $630 copay, both with no coinsurance. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H6622-075 (HMO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay per service and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-075 (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Physical and occupational therapies require a $20 copay and no coinsurance, while podiatry is not covered, and only some chiropractic services are covered with routine care and other chiropractic services being excluded.
Preventive Services See details
Humana Gold Plus H6622-075 (HMO) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management, with no copay and no coinsurance. Additional preventive services are partially covered, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Humana Gold Plus H6622-075 (HMO) covers Medicare-covered hearing exams for a $30 copay and no coinsurance, while routine exams, fitting evaluations, and OTC hearing aids are covered with no copay and no coinsurance, all with no deductible. Prescription hearing aids are partially covered with copays ranging from $699 to $999 and no coinsurance, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-075 (HMO) offers partially covered vision services with no coinsurance, no deductible, and prior authorization requirements. Covered benefits include one routine eye exam and one pair of contact lenses or eyeglasses per year with no copay up to a $250 annual limit, while other eye exams, individual eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered by Humana Gold Plus H6622-075 (HMO) up to a $2,000 annual limit, with no copay and no coinsurance for preventive care, a $25 copay and no coinsurance for restorative services, and a $30 copay and no coinsurance for Medicare-covered dental. Fluoride, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus H6622-075 (HMO) with no copay, though prior authorization and step therapy may apply. Medicare Part B chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H6622-075 (HMO) with no copay and a 20% coinsurance. Prior authorization is required before receiving these services.
Medical Equipment See details
Humana Gold Plus H6622-075 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-075 (HMO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic procedures and tests carry a $0 to $90 copay with no coinsurance, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Humana Gold Plus H6622-075 (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Humana Gold Plus H6622-075 (HMO) with no copay and no coinsurance, though prior authorization is required and only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-075 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copayment for days 1 through 20 and a $218 daily copayment for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
Other services under the Humana Gold Plus H6622-075 (HMO) plan are partially covered, featuring acupuncture for a $30 copay and no coinsurance for up to 20 treatments per year. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, though prior authorization is required for acupuncture and meal services, and other supplemental services are not covered.
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