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Humana Gold Plus H6622-099 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-099 (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 H6622-099 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-099 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Southern New Jersey. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Humana Gold Plus H6622-099 (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 H6622-099 (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 H6622-099 (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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $8550.00 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 H6622-099 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs are also highly affordable, costing as little as a $5 copay for a 1-month supply, or no copay for a 3-month supply when filled through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across standard pharmacies and mail-order options. Higher-tier medications carry coinsurance costs instead of flat copays, with Tier 4 non-preferred drugs requiring 47% coinsurance and Tier 5 specialty drugs requiring 25% coinsurance. These clear pricing tiers help you easily manage and project your prescription costs under this Medicare Advantage plan.
Additional Benefits
The Humana Gold Plus H6622-099 (HMO) plan offers robust medical coverage with many essential services featuring no copayments or coinsurance. Members pay no copay for primary care visits, preventive screenings, home health care, and routine vision and dental exams, though certain specialized services like inpatient hospital stays and emergency care require set copays. Most diagnostic services and outpatient surgical procedures also feature no coinsurance, helping to keep out-of-pocket costs predictable. For specialized needs, the plan provides coverage for hearing, vision, and dental care, including a $1,500 annual limit for dental services with no copay and a $250 annual allowance for select eyewear. Durable medical equipment and dialysis services generally require a 20% coinsurance, while prescription hearing aids and skilled nursing facility stays have tiered copays. Additionally, members benefit from acupuncture, over-the-counter items, and chronic illness meal benefits with no copay.
Inpatient Hospital See details
Humana Gold Plus H6622-099 (HMO) covers inpatient hospital services with no coinsurance, requiring prior authorization. For acute stays, there is a $360 daily copay for days 1 to 7 and no copay for additional days, while psychiatric stays require a $275 daily copay for days 1 to 7 and no copay for days 8 to 90. Some services are not covered, including room upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
Humana Gold Plus H6622-099 (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from no copay up to $450, while observation services cost a $360 copay per stay and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Humana Gold Plus H6622-099 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-099 (HMO) covers ground and air ambulance services with a $315 copay and no coinsurance, subject to prior authorization. For transportation services, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Humana Gold Plus H6622-099 (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 are available for a $35 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 H6622-099 (HMO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, and telehealth services have copays ranging from $0 to $35 and no coinsurance. Some chiropractic services are covered but routine and other chiropractic services are not covered, and podiatry services are not covered.
Preventive Services See details
Preventive services under the Humana Gold Plus H6622-099 (HMO) plan are partially covered with no copay and no coinsurance for annual physical exams, kidney disease education, fitness benefits, and select screenings. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Humana Gold Plus H6622-099 (HMO) hearing services are covered with no coinsurance, featuring a $25 copay for Medicare-covered exams and no copay for annual routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with copays ranging from $0 to $599 for up to two devices every three years, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Humana Gold Plus H6622-099 (HMO) partially covers vision services with no coinsurance and no deductibles, though prior authorization is required. Routine eye exams and select eyewear (one pair of contact lenses or eyeglasses per year up to a $250 annual limit) are offered with no copay, while other eye exams, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-099 (HMO) covers dental services with a $25 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services up to a $1,500 annual limit. The benefit is partially covered, as fluoride treatment, removable prosthodontics, 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 H6622-099 (HMO) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance. Medicare Part B insulin is also covered with a $35 copay and no coinsurance to 20% coinsurance, which does not apply to the plan-level deductible.
Dialysis Services See details
Humana Gold Plus H6622-099 (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Humana Gold Plus H6622-099 (HMO) covers durable medical equipment and prosthetic devices with a 20% coinsurance and no copay. Diabetic supplies are covered with a 10% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-099 (HMO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a copay ranging from $0 to $105. Diagnostic radiological services and outpatient X-rays feature no copays, while therapeutic radiological services require a minimum 20% coinsurance and a minimum $35 copay.
Home Health Services See details
Humana Gold Plus H6622-099 (HMO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Humana Gold Plus H6622-099 (HMO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Humana Gold Plus H6622-099 (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-099 (HMO) partially covers other services, offering acupuncture for a $25 copay and no coinsurance for up to 20 treatments per year. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, while certain other supplemental services are not covered.
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