A non-government entity
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) in 2026, please refer to our full plan details page.
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) is a HMO D-SNP plan offered by Humana Inc. available for enrollment in 2025 to people living in Pennsylvania. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP).
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 SNP-DE H6622-078 (HMO D-SNP), 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 $615.00 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:
Sign up for Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP)
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 SNP-DE H6622-078 (HMO D-SNP) plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when filling prescriptions at standard pharmacies or through preferred mail order. If you choose standard mail order for these generic tiers, copays range from $10 to $20 for a 1-month supply and $30 to $60 for a 3-month supply. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% coinsurance rate applies across standard pharmacies, preferred mail order, and standard mail order options. It covers 1-month and 3-month supplies for brand and non-preferred drugs, and 1-month supplies for specialty medications.
Additional Benefits
The Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) offers comprehensive coverage for core medical needs, including inpatient hospital stays with copays starting at $2,080 and doctor visits with no copays and 19% to 20% coinsurance. Outpatient surgery at ambulatory centers and home health services are available with no copays, while emergency room visits carry a $115 copay that is waived if admitted. For recovery, skilled nursing facility stays require no copay for the first 20 days, followed by a $218 daily copay up to day 100. For everyday wellness, this plan provides robust dental, vision, and hearing benefits, featuring a $5,000 annual dental limit and a $550 eyewear allowance with no copays. Routine hearing exams and vision tests are covered with 20% coinsurance and no copays, and prescription hearing aids are provided with no copay. Additionally, members benefit from no copays on up to 24 one-way transportation trips to plan-approved locations, alongside no copays for preventive care, over-the-counter items, and chronic illness meals.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP), as upgrades and non-Medicare-covered stays are not covered. Covered acute stays require a $2,230 copay per stay and no coinsurance, while psychiatric stays require a $2,080 copay per stay and no coinsurance, with prior authorization required for both.
Outpatient Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers outpatient services, offering ambulatory surgical center services with no copay and no coinsurance. Other covered benefits, including outpatient hospital, substance abuse, blood, and observation services, require prior authorization and carry a 20% coinsurance, with outpatient hospital services also carrying a copay of $0 to $250.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers ground and air ambulance services with a $335 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) 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 are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers primary care, specialist, and therapy services with no copays and 19% to 20% coinsurance, while telehealth services require a $0 to $40 copay and 20% coinsurance. Chiropractic care is partially covered, providing up to 12 routine visits per year with no copay and 20% coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copays and no coinsurance. Additional preventive benefits are partially covered with no copays and no coinsurance, but do not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling.
Hearing Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers hearing services with no deductible, including annual routine hearing exams for a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids (up to two every three years) and unlimited OTC hearing aids are covered with no copay or coinsurance, though prescription inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are partially covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP), offering routine eye exams with no copay and a 20% coinsurance, and eyewear with no copay or coinsurance up to a $550 annual limit. Covered eyewear includes one annual pair of contact lenses or complete eyeglasses (lenses and frames), while other eye exams, separate eyeglass lenses, separate eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) partially covers dental services, providing a $5,000 annual limit with no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require a 20% coinsurance and no copay. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) with prior authorization, featuring 0% to 20% coinsurance for Medicare Part B drugs. Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance, while other Part B drugs carry no copay and 0% to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance, subject to prior authorization.
Medical Equipment See details
Medical equipment is covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) with no copays and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic services. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers diagnostic and radiological services with prior authorization, featuring a minimum coinsurance of 19% to 20% depending on the service. Lab and diagnostic radiological services have no copay, while outpatient X-rays require a $40 copay, diagnostic tests have copays up to $40, and therapeutic radiology requires a copay.
Home Health Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) offers cardiac rehabilitation benefits with no copay and prior authorization required, though only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered by the plan and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) covers skilled nursing facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit is partially covered because prior authorization is required and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Other services are partially covered by Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP), featuring acupuncture with no copay and 20% coinsurance, and over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Highly integrated services and other optional services are not covered under this benefit.
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