© Humana 2019

*2017 Humana Member Savings Report. This report estimates average member savings by comparing the usual and customary pharmacy prices for prescription drugs purchased without insurance to an average member’s out-of-pocket costs and premiums for prescription drugs covered by their plan.

¹Most popular plans based on 2018 plan year enrollment

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.

Humana is a Coordinated Care plan with a Medicare contract and a contract with the Medicaid program. Enrollment in this Humana plan depends on contract renewal.

Discrimination is Against the Law
Humana Inc. and its subsidiaries (“Humana”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age,
disability, sex, sexual orientation, gender identity, or religion. See our website for more information. English: ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-877-320-1235 (TTY: 711). Español (Spanish): ATENCIÓN: habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al  1-877-320-1235 (TTY: 711). 繁體中文 (Chinese): 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電  1-877-320-1235 (TTY：711)。

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. We also provide free language interpreter services. See our full accessibility rights information and language options.

This information is not a complete description of benefits. Call TTY: 711 for more information.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premium and/or member cost-share may change on January 1 of each year.

Limitations on healthcare and prescription services delivered via remote access technology virtual telemedicine visits and communications options vary by state. Remote access technology services Virtual visit services are not a substitute for emergency care and not intended to replace your primary care provider or other providers in your network. This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional.

Out-of-network/non-contracted providers are under no obligation to treat Humana plan 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 us for a pre-service organization determination before you receive the service. Please call our 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 provider network may change at any time. You will receive notice when necessary.

Other ancillary providers such as labs and durable medical equipment suppliers, and pharmacies are available in our network. the Humana Cleveland Clinic Preferred HMO and D-SNP provider network. (only applicable to the Cleveland Clinic plan)

 

Other <Pharmacies/Physicians/Providers> are available in our network.  (only applicable to the Cleveland Clinic and PDP WM plan)

For residents of Florida: Sponsored by Humana and the State of Florida, Agency For Health Care Administration.

For residents of Tennessee: NOTICE:  TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts.  TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any reference to more, extra, or additional Medicare benefits, is applicable to Medicare only and does not indicate increased Medicaid benefits.

Humana’s pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of AL, CA, CT, DC, DE, GA, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV, WY; suburban areas of AZ, CA, CT, DC, DE, HI, IA, IL, IN, MA, MD, ME, MI, MN, MO, MT, ND, NH, NE, NJ, NY, OH, OR, PA, PR, RI, SD, VT, WA, WV, WY; 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: CT, DE, MA, MD, ME, MI, MN, MS, NC, ND, NY, OH, RI, SC, VT, WA; 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 whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.

Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Enrollees must continue to pay their Medicare Part B premium, their Humana plan premium, and their Optional Supplemental Benefit (OSB) premium.

$0 premium plans are not available in all areas. Plan premiums and benefits vary. You must continue to pay your Part B premium

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Last Updated: 11/06/2018