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Humana Total Complete H6622-097 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Total Complete H6622-097 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Humana Total Complete H6622-097 (HMO) in 2026, please refer to our full plan details page.
Humana Total Complete H6622-097 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Select Counties in MT. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Total Complete H6622-097 (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 Total Complete H6622-097 (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 Total Complete H6622-097 (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 $2.00. 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 $6200.00 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 Total Complete H6622-097 (HMO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is no copay for a one-month or three-month supply when using standard pharmacies or preferred mail order. Tier 2 generic drugs cost as little as a $5 copay for a one-month supply, or no copay for a three-month supply through preferred mail order. Tier 3 preferred brand drugs carry a $47 copay for a one-month supply across standard pharmacies and mail order options. For higher tier medications, Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs have a 25% coinsurance for a one-month supply. Standard mail order costs for Tier 1 and Tier 2 drugs range from a $10 to $60 copay depending on the supply duration.
Additional Benefits
The Humana Total Complete H6622-097 (HMO) plan offers comprehensive coverage for core medical needs, featuring no copay for primary care visits and a $30 copay for specialists. Inpatient hospital stays require a $425 daily copay for the first five days and no copay for days six and beyond, with no coinsurance. Emergency room care has a $115 copay, which is waived if admitted within 24 hours, while urgent care visits require a $50 copay. For additional care, the plan covers routine dental, vision, and hearing exams with no copays or coinsurance, including a $250 eyewear allowance and a $1,000 annual limit on dental services. Prescription hearing aids have copays ranging from $699 to $999, while durable medical equipment requires a 14% coinsurance with no copay. Home health services and laboratory tests are also covered with no copay and no coinsurance.
Inpatient Hospital See details
Humana Total Complete H6622-097 (HMO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, you pay a $425 daily copay for days 1 through 5 and no copay for days 6 and beyond, but upgrades and non-Medicare-covered stays are not covered. Psychiatric stays require a $416 daily copay for days 1 through 5 and no copay for days 6 through 90, while additional psychiatric days and non-Medicare-covered stays are excluded.
Outpatient Services See details
Humana Total Complete H6622-097 (HMO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center services and blood services. Outpatient hospital services require a copay of $0 to $495, observation services have a $425 copay per stay, and outpatient substance abuse sessions range from no copay to a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Humana Total Complete H6622-097 (HMO) plan with a $35.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Humana Total Complete H6622-097 (HMO) covers ambulance services with no coinsurance, requiring prior authorization and a copay of $335 for ground ambulance and $500 for air ambulance. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Humana Total Complete H6622-097 (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 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 Total Complete H6622-097 (HMO) provides primary care physician visits and mental health sessions with no copay and no coinsurance, while specialist and therapy visits require a $30 copay and no coinsurance. For chiropractic services, some services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered, and podiatry is not covered. Telehealth benefits are also available with a $0 to $50 copay and no coinsurance.
Preventive Services See details
Humana Total Complete H6622-097 (HMO) provides partially covered preventive services with no copay and no coinsurance for covered care such as annual physical exams, kidney disease education, glaucoma screenings, diabetes training, rectal exams, EKGs, and a memory fitness benefit. Supplemental services that are not covered include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Humana Total Complete H6622-097 (HMO) hearing services feature no coinsurance, offering Medicare-covered exams for a $30 copay, routine annual exams and fitting evaluations for no copay, and OTC hearing aids for no copay. Prescription hearing aids are partially covered with a copay of $699 to $999 for up to two devices per year, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Humana Total Complete H6622-097 (HMO) offers vision services with no deductibles, no copays, and no coinsurance, though prior authorization is required. The plan covers one routine eye exam per year and provides a $250 annual allowance for one pair of eyeglasses or contact lenses, but other eye exams, separate eyeglass lenses or frames, and upgrades are not covered.
Dental Services See details
Humana Total Complete H6622-097 (HMO) offers partially covered dental services up to a $1,000 annual limit, with a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for covered preventive and comprehensive services. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Total Complete H6622-097 (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, feature 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 Total Complete H6622-097 (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Humana Total Complete H6622-097 (HMO) covers medical equipment with prior authorization required. Durable medical equipment, prosthetics, and medical supplies carry a 14% coinsurance with no copay, while diabetic supplies have a 10% to 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Total Complete H6622-097 (HMO), though prior authorization is required. Lab services and outpatient X-rays have no copay, diagnostic tests have a copay ranging from $0 to $95 with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Humana Total Complete H6622-097 (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Total Complete H6622-097 (HMO) with no copay and no coinsurance, though in practice, sub-services such as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Humana Total Complete H6622-097 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 to 20 and days 51 to 100, while days 21 to 50 require a $218 daily copay, with no coverage provided for days beyond the standard Medicare limit.
Other Services See details
Humana Total Complete H6622-097 (HMO) covers acupuncture with a $30 copay and no coinsurance for up to 20 yearly treatments, alongside over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture and meal services, while other miscellaneous services in this category are not covered.
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