2018 Humana Walmart Rx Plan (PDP) S5884-164-0 in MO from Humana | HealthPocket
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Humana Walmart Rx Plan (PDP)

$20/mo
Summary of BenefitsCovered Drugs

Apply For This Plan

Zip Code63129
Applicant12/10/1983 Male
Coverage Start12/11/2018
Apply Now

Benefits & Coverage

Insurance TypeMedicare Advantage Prescription Drug Plan (Part D)
Insurance ProviderHumana
Plan IDS5884-164-0
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 $1 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)
  • was the 2nd best selling plan in Saint Louis 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$20.40
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 Walmart Rx (PDP)

StateMissouri
CountySaint Louis

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$1 copay$10 copay$1 copay
Tier 2: Non-Preferred Generic$4 copay$20 copay$4 copay
Tier 3: Preferred Brand Name23% coinsurance25% coinsurance23% coinsurance
Tier 4: Non-Preferred Brand Name35% coinsurance50% coinsurance35% coinsurance
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$3 copay$30 copay$0 copay
Tier 2: Non-Preferred Generic$12 copay$60 copay$8 copay
Tier 3: Preferred Brand Name23% coinsurance25% coinsurance20% coinsurance
Tier 4: Non-Preferred Brand Name35% coinsurance50% coinsurance35% 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 Walmart Rx (PDP) Prescription Drug Plan for Missouri

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HumanaChoice H5216-140 (PPO)
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Coventry Select (no drug) (HMO)
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Cigna-HealthSpring Advantage (HMO)
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AARP MedicareComplete (HMO)
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Essence Advantage (HMO)
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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

Medicare Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.