2018 Humana Preferred Rx Plan (PDP) S5884-111-0 in CO from Humana | HealthPocket
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Humana Preferred Rx Plan (PDP)

$369/mo
Summary of BenefitsCovered Drugs

Apply For This Plan

Zip Code80219
Applicant10/16/1983 Male
Coverage Start10/18/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Prescription Drug Plan (Part D)
Insurance ProviderHumana
Plan IDS5884-111-0
Plan Year2018
CMS Rating
Plan TypePDP
Annual Deductible$405.00
What To Know About This Plan
  • This is a drug coverage only plan
  • This plan is available for 2019. see plan
Why We Like This Plan
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)
  • was the 3rd best selling plan in Denver in 2019

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsNo
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Not Applicable
Other health plan deductibles?Yes
Health Plan DeductibleComing soon
Monthly Drug Plan Premium$30.80
Monthly Health Plan PremiumNot Applicable

Benefits

SERVICECOST
Inpatient hospital coverageComing soon
Outpatient hospital coverage20% per visit
Doctor visitsPrimary:
20% per visit
Specialist:
20% per visit
Preventive care20%
Emergency care/Urgent careEmergency:
20%
Urgent care:
20%
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
20%
Lab services:
20%
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
20%
Mental health servicesComing soon
Outpatient group therapy visit with a psychiatrist:
20%
Outpatient individual therapy visit with a psychiatrist:
20%
Outpatient group therapy visit:
20%
Outpatient individual therapy visit:
20%
Skilled Nursing FacilityComing soon
Rehabilitation servicesOccupational therapy visit:
20%
Physical therapy and speech and language therapy visit:
20%
Ambulance20%
TransportationNo
Foot care (podiatry services)Foot exams and treatment:
20%
Routine foot care:
20%
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
20% per item
Wellness programs (e.g., fitness, nursing hotline)No
Medicare Part B drugsChemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for Humana Preferred Rx (PDP)

StateColorado
CountyDenver

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$2 copay$0 copay
Tier 2: Non-Preferred Generic$1 copay$3 copay$1 copay
Tier 3: Preferred Brand Name20% coinsurance24% coinsurance20% coinsurance
Tier 4: Non-Preferred Brand Name35% coinsurance36% coinsurance35% coinsurance
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$6 copay$0 copay
Tier 2: Non-Preferred Generic$3 copay$9 copay$0 copay
Tier 3: Preferred Brand Name20% coinsurance24% coinsurance15% coinsurance
Tier 4: Non-Preferred Brand Name35% coinsurance36% coinsurance30% coinsurance
Tier 5: Specialty Tier

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - DrugsNot Rated
Appeals auto-forwardNot Rated
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Pharmacies that accept Humana Preferred Rx (PDP) Prescription Drug Plan for Colorado

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