A non-government entity
Humana Gold Plus H6622-085 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-085 (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 H6622-085 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-085 (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 2026.
It's important to know that Humana Gold Plus H6622-085 (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 H6622-085 (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 H6622-085 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.60. 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 $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 H6622-085 (HMO)
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 H6622-085 (HMO) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies and through preferred mail order for both 1-month and 3-month supplies. Tier 2 generic medications cost a $5 copay for a 1-month supply at standard pharmacies, but you can pay no copay for a 3-month supply by choosing preferred mail order. For Tier 3 preferred brand drugs, the plan charges a $47 copay for a 1-month supply at standard pharmacies and mail-order services. Higher-tier prescriptions require coinsurance rather than flat copays, with Tier 4 non-preferred drugs costing 31% coinsurance and Tier 5 specialty drugs requiring 25% coinsurance.
Additional Benefits
The Humana Gold Plus H6622-085 (HMO) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, home health care, and routine dental, vision, and hearing exams. For inpatient hospital stays, members pay a $375 daily copay for the first 5 to 6 days and no copay for the remainder of their stay. Specialist visits require a $40 copay, while emergency room services carry a $115 copay that is waived if admitted within 24 hours. Diagnostic lab tests and X-rays are covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Dental and vision benefits feature no copayments up to annual limits of $750 and $150, respectively, and hearing aids are covered with copays between $99 and $699. Additionally, skilled nursing facility stays are covered with no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Humana Gold Plus H6622-085 (HMO) covers inpatient hospital services with no coinsurance, featuring a $375 daily copay for days 1 to 6 for acute stays and days 1 to 5 for psychiatric stays, followed by no copay for the remaining covered days. Unlimited additional acute days are covered at no copay, but psychiatric additional days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Humana Gold Plus H6622-085 (HMO) with no coinsurance, featuring a $0 to $450 copay for outpatient hospital services and a $375 copay per stay for observation services. Ambulatory surgical center and blood services are provided with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by the Humana Gold Plus H6622-085 (HMO) plan with a $35.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services under the Humana Gold Plus H6622-085 (HMO) are covered with a $335 copay and no coinsurance for both ground and air transport, with prior authorization required. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Humana Gold Plus H6622-085 (HMO) 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 available with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-085 (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Additional benefits like physical therapy and mental health services require a $25 to $35 copay and no coinsurance, though podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Humana Gold Plus H6622-085 (HMO) preventive services are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, diabetes training, and a memory fitness benefit. However, the benefit is partially covered, as services like health education, in-home safety assessments, PERS, medical nutrition therapy, weight management, alternative therapies, caregiver support, and home safety devices are not covered.
Hearing Services See details
Humana Gold Plus H6622-085 (HMO) covers routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $99 to $699 and no coinsurance for up to two devices per year, though over-the-counter, 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 H6622-085 (HMO) with no deductibles and no coinsurance. Routine eye exams and eyewear (one pair of contacts or eyeglasses yearly) have no copay up to a $150 annual maximum, though other eye exams, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-085 (HMO) partially covers dental services, offering Medicare-covered dental with a $40 copay and no coinsurance, alongside preventive and comprehensive dental care with no copay and no coinsurance up to a $750 annual maximum. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-085 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Humana Gold Plus H6622-085 (HMO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Humana Gold Plus H6622-085 (HMO) medical equipment benefits cover durable medical equipment, prosthetics, 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 coinsurance.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-085 (HMO) covers diagnostic and radiological services with prior authorization required. Lab services, diagnostic radiology, and outpatient X-rays have no copay, diagnostic procedures carry a copay of $0 to $120 with no coinsurance, and therapeutic radiology requires a minimum 20% coinsurance and $40 copay.
Home Health Services See details
Home Health Services are covered by the Humana Gold Plus H6622-085 (HMO) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Humana Gold Plus H6622-085 (HMO) with no coinsurance and prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered. For these rehabilitation services, copayments range from $20 to $30 depending on the specific service.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-085 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days beyond Medicare limits are not covered.
Other Services See details
Humana Gold Plus H6622-085 (HMO) offers partial coverage for other services, which includes acupuncture for a $40 copay and no coinsurance for up to 20 treatments yearly, and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items 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