Humana Basic Rx Plan (PDP)
Health Insurance Company: Humana
Medicare Prescription Drug Part D Plan Details
- Rx
General Plan Details
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$2.00 copay (30-day supply)
$6.00 copay (90-day supply)
Tier 2: Generic
$3.00 copay (30-day supply)
$9.00 copay (90-day supply)
Tier 3: Preferred Brand
22% coinsurance (30-day supply)
22% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
45% coinsurance (30-day supply)
45% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Rx Drug Coverage - Standard Mail Order Cost
Tier 1: Preferred Generic
$2.00 copay (30-day supply)
$6.00 copay (90-day supply)
Tier 2: Generic
$3.00 copay (30-day supply)
$9.00 copay (90-day supply)
Tier 3: Preferred Brand
22% coinsurance (30-day supply)
22% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
45% coinsurance (30-day supply)
45% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Rx Drug Coverage - Preferred Mail Order Cost
Tier 1: Preferred Generic
$2.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$3.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 3: Preferred Brand
22% coinsurance (30-day supply)
22% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
45% coinsurance (30-day supply)
45% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
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