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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.
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 $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 $8500.00 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 drug deductible of $225. Under this plan, Tier 1 preferred generic drugs have no copay when filled at a standard pharmacy or through preferred mail order. Tier 2 generic drugs are also highly affordable, costing a $5 copay for a 1-month supply or no copay for a 3-month supply through preferred mail order. For brand-name and specialty medications, costs vary depending on the tier. Tier 3 preferred brand drugs carry a $47 copay for a 1-month supply at standard pharmacies and mail order. Tier 4 non-preferred drugs require a 40% coinsurance, while Tier 5 specialty drugs require a 30% coinsurance for a 1-month supply.
Additional Benefits
The Humana Gold Plus H6622-100 (HMO) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs for essential medical services. Beneficiaries enjoy no copay and no coinsurance for primary care doctor visits, preventive care screenings, and home health services. For specialized medical care, there is no coinsurance and a $20 copay for specialist visits, physical therapy, and Medicare-covered dental services, while inpatient hospital stays require a $380 copay for days one through seven. This plan also features valuable supplemental benefits, including up to a $1,500 annual dental allowance and a $200 annual vision allowance for contacts or eyeglasses with no copay. Routine hearing exams and over-the-counter hearing aids are provided with no copay and no coinsurance, while durable medical equipment is covered with no copay and a 16% coinsurance. Emergency care is accessible worldwide with a $115 copay that is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
Inpatient hospital care is covered by Humana Gold Plus H6622-100 (HMO) with no coinsurance, requiring a $380 copay for days 1 through 7 for acute care and a $295 copay for days 1 through 7 for psychiatric care, with no copay for additional covered days. Prior authorization is required, and certain services like upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Humana Gold Plus H6622-100 (HMO) covers outpatient services with no coinsurance, featuring copays ranging from no copay to $800 for outpatient hospital services and a $380 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a copay of $20 to $35 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 to receive this covered benefit.
Ambulance and Transportation Services See details
Humana Gold Plus H6622-100 (HMO) covers ground and air ambulance services with a $315 copay per service and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Humana Gold Plus H6622-100 (HMO) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered under a $115 copay and no coinsurance.
Primary Care See details
Humana Gold Plus H6622-100 (HMO) covers primary care visits with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and mental health services require a $20 copay and no coinsurance. Telehealth, opioid treatment, and other health professional services are covered 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 H6622-100 (HMO) covers preventive services, including annual physicals, kidney disease education, and select screenings with no copay and no coinsurance. This benefit is partially covered, as a memory fitness benefit is included but numerous supplemental services—such as health education, in-home safety assessments, PERS, weight management, and counseling—are not covered.
Hearing Services See details
Hearing services covered by Humana Gold Plus H6622-100 (HMO) include Medicare-covered exams for a $20 copay and no coinsurance, alongside routine exams, fitting evaluations, and OTC hearing aids for no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay of $0 to $299 for up to two devices every three years, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Humana Gold Plus H6622-100 (HMO) partially covers vision services with no coinsurance and no deductible, offering no copay for annual routine eye exams and a $200 annual allowance for contact lenses or eyeglasses. Prior authorization is required, and other eye exams, individual eyeglass lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Humana Gold Plus H6622-100 (HMO), which features a $20 copay and no coinsurance for Medicare-covered dental, and up to $1,500 annually for other covered services with no copay and either no coinsurance or 30% to 40% coinsurance. Fluoride treatment, removable prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Humana Gold Plus H6622-100 (HMO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% 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 to receive this covered benefit.
Medical Equipment See details
Humana Gold Plus H6622-100 (HMO) covers durable medical equipment with a 16% coinsurance and no copay, and prosthetics 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.
Diagnostic and Radiological Services See details
Humana Gold Plus H6622-100 (HMO) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and no coinsurance. Diagnostic procedures and tests have no coinsurance and a copay of up to $80, while outpatient X-rays require no copay, and therapeutic radiological services have a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Humana Gold Plus H6622-100 (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Humana Gold Plus H6622-100 (HMO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization. However, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Humana Gold Plus H6622-100 (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, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Humana Gold Plus H6622-100 (HMO) partially covers other services, featuring 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. Prior authorization is required for acupuncture and meal benefits, while Dual Eligible SNPs with Highly Integrated Services are not covered.
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