A non-government entity
Humana Gold Plus H6622-095 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-095 (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 H6622-095 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-095 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2025 to people living in Select Counties in Maryland. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-095 (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 H6622-095 (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 H6622-095 (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 $12.00. 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 H6622-095 (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 H6622-095 (HMO) Medicare plan has an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for a 1-month or 3-month supply at standard pharmacies or through preferred mail order. For Tier 2 generic drugs, you will pay a low $5 copay for a 1-month supply at standard pharmacies, or no copay for a 3-month supply filled via preferred mail order. Tier 3 preferred brand drugs generally require a $47 copay for a 1-month supply, which can be reduced to $131 for a 3-month supply if you use preferred mail order. Higher-tier prescriptions, such as Tier 4 non-preferred drugs and Tier 5 specialty drugs, require coinsurance payments of 48% and 25% respectively. Comparing these copayments and coinsurance options can help you maximize your savings on the Humana Gold Plus H6622-095 (HMO) plan.
Additional Benefits
The Humana Gold Plus H6622-095 (HMO) plan offers robust medical coverage with no copay or coinsurance for primary care doctor visits, routine preventive services, and home health care. For specialized care, members pay a $45 copay for specialist visits and a $335 daily copay for the first six days of acute inpatient hospital stays, after which there is no copay. Emergency room visits require a $115 copay, which is waived if admitted, while urgent care services are available for a $40 copay. This plan also features valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay, alongside a $200 annual allowance for eyewear and up to 24 one-way transportation trips per year. While many diagnostic tests, lab services, and outpatient surgeries feature no copay, members should expect a 20% coinsurance for durable medical equipment and dialysis services. Prescription hearing aids are covered with copays ranging from $699 to $999, though cardiac rehabilitation and over-the-counter items are not covered.
Inpatient Hospital See details
Humana Gold Plus H6622-095 (HMO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, you will pay a $335 daily copay for days 1-6 and no copay for days 7 and beyond, while psychiatric stays cost a $325 daily copay for days 1-6 and no copay for days 7-90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-095 (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services carry a copay of $0 to $975, observation services require a $335 copay per stay, and outpatient substance abuse sessions cost a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Humana Gold Plus H6622-095 (HMO) with a $35.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-095 (HMO) covers ground and air ambulance services with a $335 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Humana Gold Plus H6622-095 (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 care is covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are all covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-095 (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Physical, occupational, mental health, and psychiatric services are covered with a $35 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H6622-095 (HMO) covers preventive services, including annual physical exams, kidney disease education, and a memory fitness benefit, with no copay and no coinsurance. This benefit is partially covered, as supplemental services like health education, weight management, in-home safety assessments, and nutritional therapy are not covered.
Hearing Services See details
Hearing services are partially covered by Humana Gold Plus H6622-095 (HMO), featuring a $45 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fitting evaluations. Prescription hearing aids are limited to two per year with a $699 to $999 copay and no coinsurance, while inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-095 (HMO) offers partially covered vision services with no coinsurance and copays ranging from no copay to $45, featuring a $200 annual limit for eyewear. Covered benefits include annual routine eye exams, contact lenses, and eyeglasses with no copay, while other eye exams, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H6622-095 (HMO), with Medicare-covered dental requiring a $45 copay and no coinsurance, while other covered preventive and comprehensive services feature no copay and no coinsurance. 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 H6622-095 (HMO) with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered under the Humana Gold Plus H6622-095 (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Humana Gold Plus H6622-095 (HMO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copayment. Diabetic supplies are covered with a 10% to 20% coinsurance and no copayment, while diabetic therapeutic shoes and inserts require a $10 copayment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Humana Gold Plus H6622-095 (HMO), with prior authorization required. Diagnostic tests and procedures have a copay of $0 to $100 with no coinsurance, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Humana Gold Plus H6622-095 (HMO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Humana Gold Plus H6622-095 (HMO) plan. This includes standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Humana Gold Plus H6622-095 (HMO) partially covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-095 (HMO) partially covers other services, offering acupuncture for a $45.00 copay and no coinsurance for up to 20 treatments per year, and a chronic illness meal benefit 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