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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. 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 $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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is 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 a $5 copay for a 1-month supply at standard pharmacies, with no copay required for a 3-month supply filled via preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across standard pharmacies, preferred mail order, and standard mail order. Higher-tier prescriptions transition to coinsurance, with Tier 4 non-preferred drugs requiring 47% coinsurance and Tier 5 specialty drugs requiring 25% coinsurance for a 1-month supply. Understanding these copays and coinsurance rates helps you estimate your out-of-pocket prescription costs with this Humana Medicare plan.
Additional Benefits
The Humana Gold Plus H6622-099 (HMO) plan offers comprehensive coverage with no copay for primary care doctor visits, annual physical exams, and home health services, while specialist visits require a $35 copay. Inpatient hospital stays require a daily copay for the first seven days ($360 for acute, $275 for psychiatric) with no copay for subsequent days. Emergency room visits carry a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For extra benefits, the plan provides routine dental care with no copay for most covered services up to a $2,000 annual limit, as well as routine vision and hearing exams with no copay. Diagnostic tests, dialysis, and durable medical equipment are covered with copays or coinsurance up to 20%. Additionally, skilled nursing facility stays require no copay for the first 20 days.
Inpatient Hospital See details
Humana Gold Plus H6622-099 (HMO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization for stays. Acute stays require a $360 daily copay for days 1 to 7 and no copay for days 8 and beyond, while psychiatric stays require a $275 daily copay for days 1 to 7 and no copay for days 8 to 90; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-099 (HMO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $350 ($360 per stay for observation), while individual and group 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 receive these covered services.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-099 (HMO) covers Medicare-approved ground and air ambulance services with a $315 copay per trip and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and 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 require a $40 copay, 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 visits require a $35 copay and no coinsurance. Additional benefits include physical therapy, mental health, and telehealth services with copays ranging from $0 to $40 and no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Humana Gold Plus H6622-099 (HMO) covers preventive services, such as annual physical exams, kidney disease education, and a memory fitness benefit, with no copay and no coinsurance. However, these benefits are only partially covered, as services such as health education, weight management, in-home safety assessments, and medical nutrition therapy are not covered.
Hearing Services See details
Humana Gold Plus H6622-099 (HMO) hearing services include routine exams and fitting evaluations with no copay and no coinsurance, whereas Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $299 for up to two devices every three years, though inner ear, outer ear, and over-the-ear types are not covered, and over-the-counter (OTC) hearing aids are fully covered with no copay and no coinsurance.
Vision Services See details
Humana Gold Plus H6622-099 (HMO) partially covers vision services with no deductible, no coinsurance, and no copays for routine eye exams and eyeglasses or contact lenses, up to a $250 annual maximum. Prior authorization is required, and non-covered sub-services include other eye exam services, eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental services are partially covered under the Humana Gold Plus H6622-099 (HMO) plan, featuring a $35 copay and no coinsurance for Medicare-covered dental care, and no copay or coinsurance for most other covered services up to a $2,000 yearly limit. Fluoride treatments, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-099 (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while covered insulin carries a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H6622-099 (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Humana Gold Plus H6622-099 (HMO) covers durable medical equipment, prosthetic devices, 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 applicable coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Humana Gold Plus H6622-099 (HMO) with prior authorization required. Diagnostic tests feature no coinsurance and copays up to $105, lab and X-ray services have no copay, and therapeutic radiological services require a minimum $35 copay and 20% coinsurance.
Home Health Services See details
Home health services are covered by Humana Gold Plus H6622-099 (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-099 (HMO) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation 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, 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 hospital stay is not mandatory, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Humana Gold Plus H6622-099 (HMO) partially covers other services, offering acupuncture for a $35 copay and no coinsurance, as well as over-the-counter items and chronic illness meals for no copay and no coinsurance. Dual Eligible SNPs and other miscellaneous services are not covered under this plan.
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