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Humana Total Complete (HMO) Medicare Advantage Plan H6622-001 • 2027 • Winnebago County, WI

CMS Rating: Not yet rated by CMS.
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$200
Maximum Out-of-Pocket
$4200.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $500.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Winnebago County, WI
Local Enrollment
1,880 beneficiaries in Winnebago County
Last update:

Humana Total Complete (HMO) Introduction

Humana Total Complete is a Medicare Advantage HMO plan offered by Humana. It uses a Health Maintenance Organization (HMO) provider network and comes with prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $200 medical deductible, and $4200.00 in-network maximum out-of-pocket. CMS Plan ID H6622-001 identifies this plan. The 2027 Part D prescription drug deductible is $500.00.

You must live in Winnebago County, Wisconsin to enroll in this plan. CMS reports 1,880 beneficiaries enrolled in this plan in Winnebago County. For assistance with this plan, new members can call (888)873-0686 (TTY 711).

Compare Similar Plans in Winnebago County

No other HMO plans are available in Winnebago County, Wisconsin using the same plan-type comparison criteria.

Plan Benefits

Humana Total Complete has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H6622-001.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H6622-001-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $40 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0-$50 copay
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $0-$345 copay
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: $0-$145 copay
Diagnostic tests and procedures
In-network: $0-$100 copay

Emergency and Urgent Care Services

Emergency room care
$130 copay
Worldwide emergency care
Coming soon
Urgent care
$50 copay
Inpatient hospital care
Tier 1
$365 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Skilled Nursing Facility
Tier 1
$20 per day for days 1-20
$221 per day for days 21-100
Ground ambulance
In-network: $325 copay

Mental Health Services

Outpatient individual therapy
In-network: $35 copay
Outpatient group therapy
In-network: $35 copay
Inpatient psychiatric hospital care
Tier 1
$365 per day for days 1-6
$0 per day for days 7-90
$0 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $25 copay
Occupational therapy
In-network: $25 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay, 10%-20% coinsurance
Durable medical equipment
In-network: 20% coinsurance
Prosthetics
In-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance

Dental Services

Oral exam
In-network: $0 copay
Dental x-rays
In-network: $0 copay
Cleaning
In-network: $0 copay
Periodontics
In-network: 0%-30% coinsurance
Endodontics
In-network: 0%-30% coinsurance
Restorative services
In-network: 0%-30% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: 0%-30% coinsurance

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
Not covered
Eyeglass lenses only
Not covered
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
Not covered

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $575-$750 copay
OTC hearing aids
In-network: $0 copay

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
Not covered

Certain preventive services are covered 100% by Humana Total Complete as a Part B benefit.

Prescription Drug Coverage

Humana Total Complete includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Humana Total Complete (H6622-001-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$0.00
Supplemental Part D Premium:$$0.00
Total Part D Premium:$0.00
Low-Income Premium Subsidy:$6.27
Low-Income Premium Subsidy Paid by CMS:$0.00
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $500.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Humana starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Humana Total Complete may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Humana Total Complete (H6622-001-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayComing soon
Generic$5.00 copayComing soon
Preferred Brand17% coinsuranceComing soon
Non-Preferred Drug50% coinsuranceComing soon
Specialty Tier28% coinsuranceComing soon
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H6622)

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.

2027 Medicare Star Ratings for Contract H6622
CMS Measure Star Rating
2027 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 ☆☆☆☆☆
Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Humana (official source) http://www.humana.com/medicare October 4, 2026
Medicare.gov Understanding Medicare Advantage Plans 25 May, 2025
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You 25 May, 2025
Medicare.gov Compare Original Medicare & Medicare Advantage 25 May, 2025

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.