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Humana Gold Plus H6622-083 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-083 (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 H6622-083 (HMO) in 2025, please refer to our full plan details page.
Humana Gold Plus H6622-083 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Humana Gold Plus H6622-083 (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 H6622-083 (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 H6622-083 (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 a $350.00 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 $9350.00 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 H6622-083 (HMO) plan has a $350 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, for preferred generic drugs you will pay a $5 copay at preferred mail order pharmacies, while standard mail order pharmacies will have a $20 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The Humana Gold Plus H6622-083 (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, but many other services have no copay, including primary care physician visits, vision exams, and dental services. This plan also covers outpatient services, emergency services, and home health services, with copays and coinsurance applying to some services like ambulance, hearing aids, and medical equipment. Additional benefits include coverage for hearing, vision, and dental services, along with a meal benefit.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $390 copay for days 1-6, and no copay for days 7-90, with no coinsurance. For Inpatient Hospital Psychiatric, you pay a $390 copay for days 1-5, and no copay for days 6-90, with no coinsurance. Additional days for Inpatient Hospital-Acute have no copay or coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $450, observation services with a $390 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a copay between $45 and $100 for individual or group sessions, and outpatient blood services with no copay. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Humana Gold Plus H6622-083 (HMO) plan. You will have an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Humana Gold Plus H6622-083 (HMO). Ground and Air Ambulance Services have a copay of $315, with no coinsurance, but 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. Emergency Services and Worldwide Emergency Coverage, Urgent Coverage, and Emergency Transportation each have a $110 copay, while Urgently Needed Services has a $45 copay; all of these services have no coinsurance.
Primary Care See details
Primary Care benefits include coverage for primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, physician specialist services with a $20 copay, mental health specialty services with a $45 copay for individual and group sessions, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a copay between $0 and $45, and opioid treatment program services with a copay between $45 and $100. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, Annual Physical Exams with no copay, and other preventive services with a copay. Additional services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing services include hearing exams with a $20 copay, routine hearing exams with no copay for 1 visit per year, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $599 and $899 for 2 visits per year, while prescription hearing aids for the inner, outer, and over-the-ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Humana Gold Plus H6622-083 (HMO) plan covers vision services, including eye exams with a copay of $0-$20. Eyewear is covered with no copay, including contact lenses and eyeglasses (lenses and frames) with a combined maximum of $250 every year, but eyeglass lenses, frames, and upgrades are not covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $20 copay, and other dental services with no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Humana Gold Plus H6622-083 (HMO) plan. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. Other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Humana Gold Plus H6622-083 (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires prior authorization, while Diabetic Supplies have a 10-20% coinsurance with no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $120, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $325, and Therapeutic Radiological Services have a maximum copay of $20 and 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 H6622-083 (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, but not in practice. This plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Humana Gold Plus H6622-083 (HMO) plan, with no copay for days 1-20 and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Humana Gold Plus H6622-083 (HMO) plan covers acupuncture with a $20 copay, and also includes a meal benefit with no copay. Other services are not covered.
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