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Humana Gold Plus Giveback H6622-082 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus Giveback H6622-082 (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 Giveback H6622-082 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus Giveback H6622-082 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Clark and Nye 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 Giveback H6622-082 (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 Giveback H6622-082 (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 Giveback H6622-082 (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 $101.00. 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 $3900.00 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 Giveback H6622-082 (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you may pay a copay or coinsurance depending on the drug tier and pharmacy used. For preferred generic drugs, there is no copay at preferred pharmacies or through mail order, while standard pharmacies have a $0 copay and standard mail order has a $20 copay. For other tiers, coinsurance applies. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Humana Gold Plus Giveback H6622-082 (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays require a copay of $295 for the first five days, with no copay for days 6-90, while outpatient services have copays ranging from $0 to $295. The plan includes coverage for primary care with no copay, and specialist visits for $25. It also covers hearing and vision services, including routine eye exams and eyewear with no copay, and dental services with a $1,500 annual maximum.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, but require prior authorization and a doctor referral. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $295 copay for days 1-5, and no copay for days 6-90; additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered, and additional days for Inpatient Hospital Psychiatric and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $295, observation services with a $295 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $30 copay for both individual and group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for many of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Humana Gold Plus Giveback H6622-082 (HMO) plan. Ground Ambulance Services have a copay of $315, and Air Ambulance Services have a copay of $630, with no coinsurance for either. 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 this plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services have a $55 copay; all services have no coinsurance.
Primary Care See details
The Humana Gold Plus Giveback H6622-082 (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, and mental health specialty services with a $25 copay for individual and group sessions. The plan also covers podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services with a $25 copay, additional telehealth benefits with a copay between $0 and $55, and opioid treatment program services with a $30 copay.
Preventive Services See details
The Humana Gold Plus Giveback H6622-082 (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services are covered with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Some services, such as health education, in-home safety assessments, and others, are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $25 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids have a copay between $499 and $799. OTC hearing aids are covered up to $30 every three months.
Vision Services See details
The Humana Gold Plus Giveback H6622-082 (HMO) plan covers vision services including routine eye exams with a copay of $0-$25, and eyewear with a $0 copay. The plan covers contact lenses and eyeglasses (lenses and frames), but does not cover eyeglass lenses, eyeglass frames, or upgrades.
Dental Services See details
Dental services are covered, with a $1,500 maximum benefit per year. Medicare Dental Services require a $25 copay, while Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, and Oral and Maxillofacial Surgery have no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, you will pay a $35 copay and a coinsurance between 0% and 20%. For both Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance; Diabetic Equipment is also covered, with a 10-20% coinsurance for Diabetic Supplies and 20% coinsurance for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures, lab services, and radiological services. Diagnostic procedures and lab services have no copay, while diagnostic radiological services have a maximum copay of $300.00, and therapeutic radiological services have a minimum coinsurance of 20%. Outpatient X-Ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus Giveback H6622-082 (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 not covered under the Humana Gold Plus Giveback H6622-082 (HMO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with a $20 copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Humana Gold Plus Giveback H6622-082 (HMO) plan covers acupuncture with a $25 copay, up to 20 treatments per year, and also covers over-the-counter items with a $30 benefit every three months. The plan also covers a meal benefit with no copay. However, other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services are not covered.
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