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Humana Gold Plus H6622-081 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-081 (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 H6622-081 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-081 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Greater Baltimore. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-081 (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 H6622-081 (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 H6622-081 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.00. 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 $8950.00 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 H6622-081 (HMO) prescription drug plan has an annual deductible of $615. Tier 1 preferred generic drugs feature no copay for a 1-month or 3-month supply at standard pharmacies and preferred mail-order services. Tier 2 generic drugs cost $5 for a 1-month supply at standard pharmacies, or no copay for a 3-month supply through preferred mail order. Tier 3 preferred brand drugs have a $47 copay for a 1-month supply, with savings available on 3-month supplies through preferred mail order for $131. Tier 4 non-preferred drugs require a 42% coinsurance, while Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply. These options allow you to choose between standard pharmacies and mail-order services to best fit your budget.
Additional Benefits
The Humana Gold Plus H6622-081 (HMO) plan offers robust coverage for core medical needs with no coinsurance for many services, including primary care visits which feature no copay, and specialist visits with a $40 copay. Inpatient hospital stays require a $270 copay for the first eight days of acute care, while emergency room visits carry a $115 copay. Outpatient services and diagnostic tests generally feature no coinsurance, with many routine laboratory services requiring no copay. Supplemental benefits include preventive dental and routine vision care with no copay, though dental services are capped at a $1,000 annual limit and vision hardware is covered up to $200 yearly. Routine hearing exams also feature no copay, while covered prescription hearing aids require a copay between $699 and $999. For medical equipment and dialysis services, members will pay no copay but are responsible for coinsurance ranging from 19% to 20%.
Inpatient Hospital See details
Humana Gold Plus H6622-081 (HMO) covers inpatient hospital services with no coinsurance, requiring a $270 copay for days 1 through 8 of acute stays and a $275 copay for days 1 through 7 of psychiatric stays, followed by no copay for remaining covered days. Some sub-services are not covered under this plan, including room upgrades, non-Medicare-covered stays, and additional psychiatric days beyond the 90-day limit.
Outpatient Services See details
Humana Gold Plus H6622-081 (HMO) covers outpatient services with no coinsurance, although prior authorization is required for most care. Outpatient hospital copays range from $0 to $775, observation services require a $270 copay per stay, outpatient substance abuse sessions have a $35 copay, and there is no copay for ambulatory surgical center or blood services.
Partial Hospitalization See details
Humana Gold Plus H6622-081 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-081 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
Humana Gold Plus H6622-081 (HMO) covers emergency services with a $115 copay (waived if admitted within 24 hours) and urgently needed services with a $40 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-081 (HMO) features primary care physician visits with no copay and no coinsurance, while specialist visits require a $40 copay and no coinsurance. Other covered benefits, including physical therapy, mental health, and telehealth services, have no coinsurance and copays ranging from $0 to $40, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under Humana Gold Plus H6622-081 (HMO) are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and memory fitness benefits. However, additional preventive services are only partially covered, with exclusions such as health education, weight management programs, and in-home safety assessments.
Hearing Services See details
Humana Gold Plus H6622-081 (HMO) hearing services are partially covered with no coinsurance for all covered benefits. Medicare-covered exams require a $40 copay, routine exams and fitting evaluations have no copay, and covered prescription hearing aids carry a $699 to $999 copay, while OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-081 (HMO) provides partially covered vision services with no deductible, no coinsurance, and copays ranging from $0 to $40, requiring prior authorization. One routine eye exam and eyewear (contact lenses or eyeglasses) are covered with no copay up to a $200 yearly limit, but other eye exams, separate eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-081 (HMO) partially covers dental services up to a $1,000 yearly limit, featuring no copay or coinsurance for most preventive care, and no copay with 30% to 40% coinsurance for restorative and fixed prosthodontic services. Medicare-covered dental has a $40 copay and no coinsurance, while fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and removable prosthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-081 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B drugs, such as chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin drugs also requiring a $35 copay and no plan-level deductible.
Dialysis Services See details
Dialysis services are covered under the Humana Gold Plus H6622-081 (HMO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus H6622-081 (HMO) covers durable medical equipment with a 19% coinsurance and no copay, and prosthetic devices 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 and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-081 (HMO) covers diagnostic and radiological services, with prior authorization required. Diagnostic services feature no coinsurance, offering no copay for lab services and a $0 to $95 copay for diagnostic procedures. Radiological services include outpatient X-rays and diagnostic radiology with a $0 minimum copay, while therapeutic radiology requires a minimum $40 copay and 20% coinsurance.
Home Health Services See details
Humana Gold Plus H6622-081 (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-081 (HMO) covers some cardiac rehabilitation services with no copay, no coinsurance, and prior authorization required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Humana Gold Plus H6622-081 (HMO), which excludes coverage for additional days beyond the Medicare-covered limit. Covered stays require no coinsurance and prior authorization, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100.
Other Services See details
Humana Gold Plus H6622-081 (HMO) partially covers other services, offering acupuncture with a $40 copay and no coinsurance for up to 20 treatments yearly, and a chronic illness meal benefit with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan.
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