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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 2025, 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 2025.
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 $6.00. 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 $4150.00 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) plan has no deductible for prescription drugs. During the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay a $10 copay for preferred generic drugs at preferred and standard pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for covered Part D drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Humana Gold Plus H6622-075 (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $375 copay for the first five days, while outpatient services have copays ranging from $0 to $325. Emergency and urgent care services come with copays of $55-$140. This plan includes coverage for primary care with no copay, and specialist visits with a $40 copay, alongside preventive services with no copay. Vision and dental services are also included, with no copays for eye exams, eyewear, and many dental services. Hearing exams have a $40 copay.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $375 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while non-Medicare covered stays and upgrades 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 $375 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have a $30 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Humana Gold Plus H6622-075 (HMO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Humana Gold Plus H6622-075 (HMO) plan, with no coinsurance for any ambulance services. Ground ambulance services have a $315 copay, and air ambulance services have a $630 copay, while 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 H6622-075 (HMO) plan. Emergency Services has a $140 copay with no coinsurance, Urgently Needed Services has a $55 copay with no coinsurance, and Worldwide Emergency Services have a $140 copay with no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Humana Gold Plus H6622-075 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $20 copay, physician specialist services with a $40 copay, mental health specialty services with a $30 copay, physical therapy and speech-language pathology services with a $20 copay, and additional telehealth benefits with a copay between $0 and $55. Psychiatric services and opioid treatment program services are covered with a $30 copay. Podiatry services are not covered.
Preventive Services See details
The Humana Gold Plus H6622-075 (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit are covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
The Humana Gold Plus H6622-075 (HMO) plan covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are covered up to $50 every three months.
Vision Services See details
The Humana Gold Plus H6622-075 (HMO) plan covers vision services, including eye exams with a copay of $0-$40, and eyewear with no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, and a combined maximum benefit of $150 per year, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Humana Gold Plus H6622-075 (HMO) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and other preventive dental services, but does not cover fluoride treatment. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis, and other preventive dental services have no copay. Restorative services have a $25 copay, and adjunctive general services have no copay. The plan has a maximum benefit of $2,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Humana Gold Plus H6622-075 (HMO) plan, including Medicare Part B Insulin Drugs with a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs also have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
The Humana Gold Plus H6622-075 (HMO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance and requires prior authorization. Prosthetics/Medical Supplies are covered with no copay and a 20% coinsurance, while Diabetic Supplies have a 10-20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, lab services, and all radiological services. Diagnostic Procedures/Tests have a copay between $0 and $90, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $375, while Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-075 (HMO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Humana Gold Plus H6622-075 (HMO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, with a copay of $20 for days 1-20 and $214 for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the Humana Gold Plus H6622-075 (HMO) plan, acupuncture has a $40 copay, and is limited to 20 treatments per year. Over-the-counter items are covered, with a maximum benefit coverage amount of $50.00 every three months. The plan also covers a meal benefit with no copay, and covers meals for a chronic illness. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and more are not covered.
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