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Humana Gold Plus H6622-100 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Humana Gold Plus H6622-100 (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 H6622-100 (HMO) in 2026, please refer to our full plan details page.
Humana Gold Plus H6622-100 (HMO) is a HMO plan offered by Humana Inc. available for enrollment in 2026 to people living in Northern 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 H6622-100 (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 H6622-100 (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 H6622-100 (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 $225.00 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 $8850.00 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 H6622-100 (HMO) prescription drug plan features an annual deductible of $225. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for a one-month or three-month supply at standard pharmacies and through preferred mail order. Tier 2 generic drugs cost $5 for a one-month supply at standard pharmacies, with no copay required for a three-month supply filled via preferred mail order. For Tier 3 preferred brand drugs, members pay a $47 copay for a one-month supply at standard pharmacies or through mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs require coinsurance instead of copays, costing 40% and 30% coinsurance respectively across all available pharmacy options. This structured coverage makes the Humana Gold Plus H6622-100 (HMO) plan a reliable choice for managing diverse medication needs.
Additional Benefits
The Humana Gold Plus H6622-100 (HMO) offers comprehensive healthcare coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $20 copay, while emergency care is available for a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For hospital stays, inpatient acute care requires a $345 daily copay for the first seven days, after which there is no copay. This plan also includes strong routine benefits, featuring no copay or coinsurance for preventive dental care up to a $2,000 annual limit, as well as routine vision and hearing exams. Prescription hearing aids are covered with a copay of up to $299 for up to two devices every three years, and the plan provides up to $250 annually for eyewear with no copay. Durable medical equipment carries a 16% coinsurance with no copay, while diagnostic lab services require no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Humana Gold Plus H6622-100 (HMO) with no coinsurance, requiring a $345 daily copay for days 1 to 7 of acute stays and a $260 daily copay for days 1 to 7 of psychiatric stays, followed by no copay for remaining covered days. Prior authorization is required, and non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-100 (HMO) covers outpatient services with no coinsurance, requiring prior authorization for most care. Outpatient hospital services have a copay of $0 to $450 ($345 per stay for observation services) with no coinsurance, outpatient substance abuse sessions carry a $20 to $35 copay with no coinsurance, and both ambulatory surgical center and blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Humana Gold Plus H6622-100 (HMO) covers partial hospitalization services with a $35.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-100 (HMO) covers ground and air ambulance services with a $315 copayment and no coinsurance, requiring prior authorization. While transportation services are technically covered, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Humana Gold Plus H6622-100 (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services are available for a $40 copay with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-100 (HMO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and psychiatric visits require a $20 copay and no coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, though routine and other chiropractic services are not covered, and podiatry is entirely excluded. Additional telehealth benefits are also available with a $0 to $40 copay and no coinsurance.
Preventive Services See details
Humana Gold Plus H6622-100 (HMO) covers preventive services, including annual physical exams, kidney disease education, and memory fitness, with no copay and no coinsurance. This benefit is partially covered because 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 technologies, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are covered by Humana Gold Plus H6622-100 (HMO), featuring a $20 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with a copay of up to $299 and no coinsurance for up to two devices every three years, excluding inner ear, outer ear, and over the ear hearing aids which are not covered.
Vision Services See details
Humana Gold Plus H6622-100 (HMO) offers partially covered vision services with no deductible, no coinsurance, and copays ranging from $0 to $20, with prior authorization required. The plan covers one routine eye exam with no copay and up to $250 annually for contact lenses or eyeglasses with no copay, while other eye exams, separate lenses or frames, and upgrades are not covered.
Dental Services See details
Humana Gold Plus H6622-100 (HMO) offers partially covered dental services up to a $2,000 annual limit, featuring no copay and no coinsurance for preventive care, though fluoride treatment is not covered. Medicare-covered dental services require a $20 copay and no coinsurance, while covered comprehensive services have no copay and either no coinsurance or a 30% to 40% coinsurance. Removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Humana Gold Plus H6622-100 (HMO) with no copay, requiring prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin carries a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Humana Gold Plus H6622-100 (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 H6622-100 (HMO) covers durable medical equipment (DME) with a 16% coinsurance and no copay, and 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 no coinsurance, with prior authorization required for most medical equipment.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-100 (HMO) covers diagnostic and radiological services, offering lab services with no copay and no coinsurance, and diagnostic tests with a copay of $0 to $80 and no coinsurance. Diagnostic radiological services start at a $0 copay with no coinsurance, outpatient X-rays have no copay but require coinsurance, and therapeutic radiological services require both a copay and at least 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Humana Gold Plus H6622-100 (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Humana Gold Plus H6622-100 (HMO) with no coinsurance and require prior authorization, though only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H6622-100 (HMO) with no coinsurance, requiring prior authorization but allowing admission without a prior three-day 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 H6622-100 (HMO) partially covers other services, offering acupuncture for a $20 copay and no coinsurance, as well as over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Sub-services including Other 1, Other 2, Other 3, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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