4 out of 5 stars* for plan year 2024
$0.00 Monthly Premium
Humana Gold Plus H6622-063 (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H6622-063-000
$0.00 Monthly Premium
New Jersey Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about New Jersey Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
Coverage | Details |
---|---|
Monthly plan premium | $0.00 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $225.00 |
Out-of-pocket maximum | $8,850.00 |
Initial drug coverage limit | $0.00 |
Catastrophic drug coverage limit | $8,000.00 |
Primary care doctor visit | In-Network: Doctor Office Visit: |
Specialty doctor visit | In-Network: Doctor Specialty Visit: |
Inpatient hospital care | In-Network: Acute Hospital Services: |
Urgent care | Urgent Care: Copayment for Urgent Care $55.00 Worldwide Coverage: |
Emergency room visit | Emergency Care: Copayment for Emergency Care $100.00 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours Worldwide Coverage: |
Ambulance transportation | In-Network: Ground Ambulance: Air Ambulance: Please see Evidence of Coverage for Prior Authorization rules |
Health Care Services and Medical Supplies
Humana Gold Plus H6622-063 (HMO) covers a range of additional benefits. Learn more about Humana Gold Plus H6622-063 (HMO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage | Details |
---|---|
Chiropractic services | In-Network: Chiropractic Services:
|
Diabetes supplies, training, nutrition therapy and monitoring | In-Network: Diabetic Supplies and Services: |
Durable medical equipment (DME) | In-Network: Durable Medical Equipment: |
Diagnostic tests, lab and radiology services, and X-rays | In-Network: Outpatient Diag Procs/Tests/Lab Services: Outpatient Diag/Therapeutic Rad Services: |
Home health care | In-Network: Home Health Services: |
Mental health inpatient care | In-Network: Psychiatric Hospital Services: |
Mental health outpatient care | In-Network: Outpatient Mental Health Services: |
Outpatient services/surgery | In-Network: Outpatient Hospital Services: Outpatient Observation Services: Ambulatory Surgical Center Services: |
Outpatient substance abuse care | In-Network: Outpatient Substance Abuse Services: |
Over-the-counter items | In-Network: Over-The-Counter (OTC) Items: |
Podiatry services | In-Network: Podiatry Services: |
Skilled Nursing Facility (SNF) care | In-Network: Skilled Nursing Facility Services: |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Dental care | In Network: 0% coinsurance for comprehensive oral evaluation or periodontal exam up to 1 every 3 years.0% coinsurance for panoramic film or diagnostic x-rays up to 1 every 5 years.0% coinsurance for bitewing x-rays, intraoral x-rays up to 1 set(s) per year.0% coinsurance for emergency diagnostic exam up to 1 per year.0% coinsurance for fluoride treatment, periodic oral exam, prophylaxis (cleaning) up to 2 per year.0% coinsurance for periodontal maintenance up to 4 per year.0% coinsurance for necessary anesthesia with covered service up to unlimited per year.$25 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years.$25 copayment for scaling for moderate inflammation up to 1 every 3 years.$25 copayment per tooth for amalgam and/or composite filling up to unlimited per year.$2,000 maximum benefit coverage amount per year for preventive and comprehensive benefits. Out of Network: |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Vision benefits | In-Network: Eye Exams:
Eyewear:
Prior Authorization Required for Eyewear |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Hearing benefits | In-Network: Hearing Exams:
Prior Authorization Required for Hearing Exams Hearing Aids:
|
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening
Yearly "Wellness" visit |
Prescription Drug Costs and Coverage
The Humana Gold Plus H6622-063 (HMO) offers prescription drug coverage, with an annual drug deductible of $225.00 (excludes Tiers 1, 2 and 3)
Coverage | Cost |
---|---|
Coverage & Cost | |
Annual drug deductible | $225.00 (excludes Tiers 1, 2 and 3) |
Tier 1 | |
Tier 2 | |
Tier 3 | |
Annual drug deductible | $225.00 (excludes Tiers 1, 2 and 3) |
Tier 1 | |
Tier 2 | |
Tier 3 | |
Annual drug deductible | $225.00 (excludes Tiers 1, 2 and 3) |
Tier 1 | |
Tier 2 | |
Tier 3 |
When reviewing New Jersey Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of New Jersey that offer similar benefits at similar or lower prices than the plan above. Call 1-855-298-6309 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
Links to plan documents |
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New Jersey Counties Served
Bergen Essex Hudson Hunterdon Middlesex Monmouth Morris Ocean Passaic Somerset Sussex Union Warren
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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