What Types of Medicare Part D Coverage Does Humana Offer?

Last Updated : 10/21/20186 min read

Medicare Part D prescription drug coverage is available through Medicare-contracted private insurance companies such as Humana. How you can get it depends on whether you’re enrolled in Original Medicare or Medicare Part C (Medicare Advantage).

Whether you’re new to Medicare or interested in finding coverage that lowers your prescription drug costs, here’s what you need to know about Humana Medicare Part D prescription drug coverage.

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What types of Humana Medicare Part D coverage are available?

Humana Medicare Part D coverage is available in two ways: As part of a Medicare Advantage plan (also known as Medicare Advantage Prescription Drug plan) or through a stand-alone Humana Medicare Prescription Drug Plan that works alongside Original Medicare.

If you are enrolled in a Humana Medicare Advantage plan that includes prescription drug coverage, you generally should not enroll in a stand-alone Medicare Part D Prescription Drug Plan. If you do, you’ll be automatically disenrolled from your Medicare Advantage plan and returned to Original Medicare (Part A and Part B). The exception to this is if you’re enrolled in a Medicare Advantage plan that doesn’t offer prescription drug benefits, such as a Medicare Savings Account plan or certain Private Fee-for-Service plans. In these cases, you’re allowed to enroll in a stand-alone Medicare Prescription Drug Plan for your Part D coverage.

It’s important to enroll in a Medicare plan with prescription drug coverage as soon as you are eligible; if you wait to get Medicare Part D after you’re first eligible and don’t have other creditable prescription drug coverage (insurance that is as good as Part D) for 63 days in a row or more, you may have to pay a late-enrollment penalty with your Part D premium for as long as you are covered.

All Humana Medicare Advantage plans currently include Part D prescription drug coverage, but plan benefits are subject to change from year to year. However, always confirm with the specific Medicare Advantage plan you’re considering if you’re interested in Part D coverage.

How does Humana Medicare Part D coverage work?

The Medicare program requires that all private insurance companies that offer Part D coverage provide a minimum level of benefits to enrollees. For example, Medicare plans that offer prescription drug benefits must cover at least two medications from certain required drug classes. If you’re getting your prescription drug coverage through a Medicare Advantage plan, your plan may include extra benefits under Part C, such as routine vision or dental, hearing, or wellness programs.

Each Medicare Prescription Drug Plan and Medicare Advantage Prescription Drug plan includes a formulary, or list of covered prescription medications; your plan may change its formulary at any time, but you must be notified in writing of any changes before they take effect.

Some Humana Medicare Part D Prescription Drug Plans and Medicare Advantage plans with Part D coverage require you to use a network of pharmacies in order for your medications to be covered. Others use a tiered formulary, in which generic medications may have a lower copayment and/or be exempt from deductible requirements, while more expensive medications in a higher tier may have higher copayments, coinsurance, and deductible requirements. Generally, covered medications on higher tiers have higher cost sharing than those that fall on lower tiers.

Please keep in mind that not all Humana Medicare Advantage and Medicare Part D Prescription Drug Plans may be available in every service area, and that Humana may offer different benefits in different areas of the country. In addition, premiums and cost-sharing expenses for different Humana Medicare plans may vary depending on the service area.

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Other things to keep in mind about Humana Medicare Part D coverage:

  • You will pay a separate monthly payment, in addition to your Part B premium, for your stand-alone Part D Prescription Drug Plans. If your Humana MedicareAdvantage plan includes prescription drug coverage, the cost for your Part D coverage is included in your plan premium. In both situations, you’ll need to keep paying your Part B premium.
  • Some Humana Medicare plans that cover prescription drugs may have certain coverage rules, such as limiting the number of pills or doses of medication your pharmacist can dispense at one time, or over a particular period of time; these types of restrictions are known as quantity limits. Or, you may be required to try a similar and/or less expensive medication before your plan will approve coverage for a more expensive one (if it’s shown that the more expensive prescription drug is medically necessary and/or more effective for treating your condition). This coverage rule is known as step therapy.

Because Medicare plans that offer Part D coverage can vary significantly when it comes to costs, taking the time to browse and compare Medicare prescription drug coverage available to you can help you save money. If you’d like to learn more about Humana Medicare Part D coverage, you can take a look at the Humana page right now. To start comparing plan options, click the Find Plans button to view what’s available in your location; you can even enter your list of current prescription drugs to narrow your search to Medicare plan options that cover your medications. Would you rather speak with someone about your Medicare questions?

*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. [Benefits, premiums and/or member cost-share] may change on January 1 of each year.

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

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.

***Humana Inc. and its subsidiaries (“Humana”) do not discriminate on the basis of race, color, national origin, age, disability, or sex.

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