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What Types of Medicare Part D Plan Coverage Does Humana Have?

November 03, 2017

If you’re new to Medicare and looking to understand your different prescription drug coverage options, you’ve come to the right place. Medicare prescription drug plan coverage, or Part D, is available through Medicare-approved private insurance companies like Humana.

Humana offers a couple different plan options for Medicare beneficiaries who’d like help paying for their prescription drug costs. Here is an overview of the different ways you may be able to get Part D coverage through a Medicare Prescription Drug Plan offered by Humana.

What types of Medicare Part D Plans are available through Humana?

Humana offers Medicare Part D coverage in two ways. If you’re enrolled in Original Medicare, you can enroll in a stand-alone Medicare Prescription Drug Plan that works alongside your Part A and Part B benefits. Humana currently offers a few different options, all at different price points to suit your needs:

  • Humana Walmart RX Plan
  • Humana Preferred RX Plan
  • Humana Enhanced Plan 

If you decide to go this route, you’d continue to get your hospital and medical coverage through Original Medicare, but your prescription drug benefits would be administered through your Humana Prescription Drug Plan. Keep in mind that you will have a separate plan premium for your Part D coverage with Humana, as well as separate copayments, coinsurance, and deductible costs. These costs may vary depending on which of Humana’s Medicare Prescription Drug Plans you choose, as well as the type of medications you take. You will still have to pay your Part B premium.

Alternatively, Humana also offers Medicare Part D coverage through its Medicare Advantage Prescription Drugs plans. As part of the Part C program, Medicare Advantage plans are a different way to get the same Part A and Part B benefits. The main difference is that instead of getting your benefits through the federal Medicare health-care program, you’ll get them administered directly through your Medicare Advantage plan from Humana. All Medicare Advantage plans, including those available through Humana, are required to offer at least the same level of coverage as Original Medicare, but may include extra coverage, such as prescription drug benefits, routine vision or dental, and even wellness programs such as SilverSneakers.

If you decide to get your prescription drug coverage this way, you can get your Part A, Part B, and Part D coverage all under a single plan known as a Medicare Advantage Prescription Drug plan. There is no need to enroll in a separate plan for your prescription drug coverage. If you enroll in a Medicare Advantage Prescription Drug plan and then enroll in a stand-alone Humana Prescription Drug Plan, you may be automatically disenrolled from your Medicare Advantage plan and returned to Original Medicare Part A and Part B. Medicare Advantage Prescription Drug plans also come with their own costs, which generally include premiums, copayments, coinsurance, or deductibles. In addition, as in the case with Medicare stand-alone Prescription Drug Plans, you’ll need to keep paying your monthly Part B premium.

Currently, Humana offers the following Medicare Advantage plans:

  • Humana Gold Plus HMO
  • HumanaChoice PPO
  • Humana Gold Choice PFFS

Not every Medicare plan offered by Humana is available in every location. If you’re interested in getting Part D coverage through Humana, make sure to browse plan options in your zip code to get the most accurate availability.

How does Medicare Part D coverage with Humana work?

As mentioned, Medicare Part D costs vary across Humana’s different plans. Similarly, different plans cover different prescription drugs as well. Whether you get your prescription drug benefits through a stand-alone Medicare Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, it’s important to always be sure that the plan you’re considering covers the medications you need before enrolling.

One way to do this is to look up the plan’s formulary, or list of covered drugs. A Medicare Prescription Drug List on Humana’s website makes it convenient to search its database of covered medications; you can use the search tool to look up your prescriptions by name. Medicare plans with Part D coverage divide covered medications into “tiers,” and the medications on each tier come with different cost sharing. Generic medications are usually on lower tiers and have lower copayments, coinsurance, and deductibles; brand-name medications are typically on higher tiers and come with higher costs. Keep in mind that Humana may change a plan’s formulary at any time; however, you’ll be notified when necessary.

Other factors that might affect your costs include whether you enter the coverage gap (“donut hole”); whether your plan requires you to use in-network pharmacies to fill prescriptions; and whether you use the Humana Pharmacy’s prescription mail order program. Always read through the coverage rules for your plan carefully. Your Evidence of Coverage manual lists out the benefits and rules for your plan and is a good place to start understanding your coverage. You should get a copy of this document when you enroll in a plan, or you can request it by contacting Humana.

As you can tell, Humana offers a variety of choices when it comes to Medicare Part D coverage. If you’re ready to find Medicare Part D options from Humana, you are welcome to speak with an eHealth licensed insurance agent about Medicare plans from Humana: call 1- 888-323-1149, TTY users dial 711. Monday through Friday, 8AM to 8PM ET. Or, to browse plan options on your own, just enter your zip code into the tool on this page to get started.

 

The product and service descriptions, if any, provided on these eHealth/PlanPrescriber Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

Coverage may be limited to Medicare-eligible expenses. Benefits vary by plan and the premium will vary with the amount of benefits selected. Depending on the plan chosen you may be responsible for deductibles and coinsurance before benefits are payable. These policies have exclusions and limitations; please call your agent/producer or Humana for complete details of coverage and costs.

*Humana’s pharmacy network offers limited access to pharmacies with preferred cost sharing in urban areas of AL, CA, CT, DC, DE, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV; suburban areas of AZ, CA, CT, DE, HI, IL, MA, MD, ME, MI, MN, MT, ND, NH, NJ, NY, OH, OR, PA, PR, RI, VT, WA, WV; and rural areas of <AK, IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: DE, MA, MD, ME, MI, MN, MS, ND, NY, OH, SC, and VT; suburban areas of: MT and ND; and rural areas of: ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.

**Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations. For a decision about whether Humana will cover an out-of-network service, we encourage you or your provider to ask Humana for a pre-service organization determination before you receive the service. Please call Humana’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Humana is a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. [Benefits, premiums and/or member cost-share] may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.

Last Updated: 11/3/2017

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