Humana Gold Plus H6622-026 (HMO-POS) Plan Details for Yancey County, NC
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*CMS rated this Humana plan (H6622-026-0) 3.5 (Above Average) out of 5 stars.
Humana Gold Plus H6622-026 (HMO-POS) is a Medicare Advantage plan with prescription drug benefits. Eligibility applies. Enroll online today.
See more Medicare Advantage Plans in Yancey County, North Carolina.
Humana Gold Plus H6622-026 Basic Details
| Plan Basics | |
|---|---|
| Plan ID: | H6622-026-0 |
| Plan Type: | HMO-POS |
| Plan Year: | 2025 |
| Premium: | $23.90/mo Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Out-of-Pocket Maximum: | 9,350.00 /yr (in-network) |
| Part B Reduction: | $0.00/mo |
| Drug Plan Benefit: | Enhanced, $350.00 deductible |
| Supplemental Benefits: | Vision, Hearing |
| Availability: | Yancey County, NC |
| Insured By: | Humana |
| Summary of Benefits |
|---|
Humana Out-of-Pocket Costs
This Humana Part C plan has cost-sharing. These are costs you pay out-of-pocket when you use approved health services. The following table summarizes the most common in-network out-of-pocket costs in plan H6622-026-0.
NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
Doctor's Office Visits
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | $0 Copay |
| Specialist: | $30 Copay Prior Authorization Required |
Emergency, Urgent, and Inpatient Hospital Coverage
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $110 Copay |
| Urgent care: | $45 Copay |
| Ground ambulance: | $315 Copay |
| Inpatient hospital care: | $399.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 and beyond |
Foot Care
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $30 Copay Prior Authorization Required |
| Routine Foot Care: | Not Covered |
Chiropractic Care
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
| Routine chiropractic: | Not Covered |
Mental Health Services
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $45 Copay |
| Outpatient group therapy: | $45 Copay |
| Inpatient psychiatric hospital care: | $399.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Rehabilitation Services
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $25 Copay Prior Authorization Required |
| Occupational therapy: | $25 Copay Prior Authorization Required |
Medical Equipment and Supplies
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 10% Coinsurance Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $325 Copay Prior Authorization Required |
| Lab services: | $50 Copay Prior Authorization Required |
| Outpatient x-rays: | $130 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $120 Copay Prior Authorization Required |
Medicare Part B Drugs
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
Dental Services
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $30 Copay Prior Authorization Required |
| Oral exam | $0 Copay |
| Dental x-rays | $0 Copay |
| Cleaning | $0 Copay |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
| Maximum dental benefit: | $2,000.00 (Every year) |
Hearing Aids and Services
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Covered Limits may apply |
Vision Services
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam | $ to $30 Copay |
| Routine eye exam | $0 Copay 1 Every year |
| Eyewear benefits | Eyeglasses: No Contact Lenses: No Eyeglass Lenses: No Eyeglass Frames: No Eyewear Upgrades: No |
| Maximum eyewear benefit: | $2.00 Every three years |
Feel free to download our Humana Gold Plus H6622-026 Summary of Benefits information.
Prescription Drug Costs & Benefits
Humana Gold Plus H6622-026 includes enhanced benefit Medicare Part D. Enhanced benefits offer greater coverage than basic, typically providing lower cost-sharing, broader drug coverage, and additional benefits, such as covering drugs not included in the standard formulary. These plans usually have higher premiums due to the extra coverage and flexibility they provide, but they cover a larger percentage of overall drug costs.
As of 2023, approximately 75% of people on Medicare are enrolled in enhanced plans.
Prescription Drug Premium with Extra Help
Extra Help is a Social Security program that helps people with limited income and resources lower or cut Part D costs. The following table outlines premium assistance details with Extra Help.
| Low Income Premium Subsidy: | $51.22 |
| Low Income Premium Subsidy CMS Pays: | $23.90 |
| Low Income Subsidy Premium: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Deductible
The Medicare Part D annual deductible with this plan is $350.00. You must pay this amount at the pharmacy before Humana begins paying its share.
Prescription Drug Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Humana Gold Plus H6622-026 has out-of-pocket costs you must pay when you pick up your prescriptions.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic* | $0.00 | $10.00 | |
| Generic* | $5.00 | $20.00 | |
| Preferred Brand | $47.00 | $47.00 | |
| Non-Preferred Drug | 40.00% | 40.00% | |
| Specialty Tier | 28.00% | 28.00% | |
| *The Part D deductible does not apply. | |||
CMS 5-Star Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates health plans (Part C) and drug plans (Part D) in several major categories using a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join Humana Gold Plus H6622-026 .
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Additional Plan Options
The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:
- Humana Gold Plus H6622-014 (HMO-POS)
- Humana USAA Honor Giveback (HMO)
- Humana Gold Plus H6622-004 (HMO)
- Humana Gold Plus H6622-054 (HMO)
- Humana Gold Plus Giveback H6622-090 (HMO)
- Humana Gold Plus H6622-026 (HMO-POS)
- Humana Gold Plus H6622-066 (HMO)
If you are enrolled in a Part C plan with prescription drug coverage, you cannot be enrolled in a stand-alone Medicare Part D plan, regardless of your chosen insurance company.
You cannot be enrolled in a Part C health plan and simultaneously hold Medicare Supplement Insurance (Medigap). Medicare Supplement plans are only compatible with Medicare Parts A and B.
Contact Us About Humana
| Website: | Humana Plan Page |
|---|---|
| Providers: | Humana Providers Page |
| Formulary: | Humana Formulary Page |
| Pharmacy: | Humana Pharmacy Page |
| New Member Health Plan Help: | (800)833-2364 |
| New Member Health Plan TTY: | 711 |
| New Member Part D Help: | (800)833-2364 |
| New Member Part D TTY Users: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part C program on www.medicare.gov or call 1-800-MEDICARE.
Citations & References
- Humana, http://www.humana.com/medicare, Last Accessed March 1, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed February 19, 2024
- Medicare.gov, "Is Your Test, Item, or Service Covered?", Last Accessed March 19, 2025
- CMS.gov, Landscape Source Files, Last Accessed March 15, 2025
- CMS.gov, Medicare Part C & D Performance, Last Accessed March 15, 2025
- CMS.gov, Plan Benefits Package,Last Accessed March 15, 2025
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Disclosure
Many of the plans featured here are available through our partner, HealthCompare, who may compensate us when you enroll. This does not influence our content, which is based on independent research. Our opinions are our own. Learn more.
To ensure accuracy and compliance with CMS guidelines, MedicareWire's plan pages are reviewed annually by compliance officers from UnitedHealthcare (UHC), Humana, and Aetna.