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Medicare Advantage · HMO
Humana
Plan year 2026
Humana Gold Plus SNP-DE H6622-048 (HMO D-SNP) H6622-048
Monthly premium
$16.60
+ your Part B premium
Max out-of-pocket
$9,250
in-network annual cap
Primary care
$0
per visit copay
Specialist
$0
per visit
Integration status
CO
Common dual-eligibility labels
These definitions are educational. They do not confirm which Medicaid categories this specific plan accepts.
FBDE
Full Medicaid benefits in addition to Medicare.
QMB+
QMB help with Medicare costs plus full Medicaid benefits.
SLMB+
SLMB help with the Part B premium plus full Medicaid benefits.
QMB
Help with Medicare premiums and Medicare-covered cost sharing.
Check the Summary of Benefits or Evidence of Coverage for the exact Medicaid levels this plan accepts.
Could a Medicare Savings Program help?
Medicare Savings Programs are run by each state. The 2026 federal baseline monthly income limits are:
- QMB: $1,350 for one person or $1,824 for a married couple
- SLMB: $1,616 for one person or $2,184 for a married couple
- QI: $1,816 for one person or $2,455 for a married couple
Alaska, Hawaii, and some states use different limits or resource rules. Qualifying for an MSP does not by itself confirm eligibility for this D-SNP. Apply through your state Medicaid office.
Extra benefits for members who qualify
- Food and produce benefit
- Non-medical transportation benefit
- General supports for living
- Pest control service
- Indoor air quality equipment and services
- Social needs benefit
These benefits are not available to every member. Even if you have a listed chronic condition, the plan must confirm that you meet its coverage criteria. See the Evidence of Coverage for complete rules.
Your costs at a glanceIn-network, for the 2026 plan year
Rx deductible
$615
Inpatient hospital
$0
no limit on covered hospital days
Inpatient mental health
$0
Outpatient surgery
$0
Emergency room
$0
Urgent care
$0
Medicare cost sharing is $0 for members enrolled in this plan with Medicaid. If you lose Medicaid eligibility, you may be billed cost sharing.
What's included, and what it's actually worth7 benefits included. Tap any card for the detail
Dental
$2,000/yr allowance
Annual max$2,000/yr allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Vision
$350/yr eyewear allowance
Eyewear allowance$350/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
Doctor Visits: Specialist$0 copay
Inpatient Hospital$0
Outpatient Surgery$0 copay
Mental Health$0
Hearing$0 copay per hearing aid
OTC allowanceOTC card
Fitness$0 fitness benefit
Transportation36 one-way trips/year
MealsMeal benefit
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Tier 1
$0
Preferred Generic
Tier 2
$0
Generic
Tier 3
25%
Preferred Brand· after deductible
Tier 4
25%
Non-Pref Brand· after deductible
Tier 5
25%
Specialty· after deductible
Our take
Where this plan shines
See your primary doctor for $0.
The specialist copay ($0) is among the more affordable options.
Things to know before you enroll
This plan’s out-of-pocket maximum is above the national median.
Network restriction — you’ll need to use in-network providers except in emergencies.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)
Plan documents
Summary of Benefits (PDF)
Download the plan's official Summary of Benefits document
Evidence of Coverage (PDF)
Complete plan details and rules
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (888)873-0686 (TTY: 711) para solicitar documentos en español