Focus on Humana Pharmacy Solutions

Refilling a prescription

Aug. 29, 2011

Aug. 29, 2011

As you think about affordable options for your retirees, Humana's innovation offers a variety of plans to fit your needs and those of your retirees.

While you review available options for 2012, don't forget Humana Pharmacy Solutions is here to help. Providing benefits for your retirees becomes more of a challenge all the time.

Prescription drug use continues to rise dramatically. The Centers for Medicare & Medicaid Services (CMS) estimates that in 2011, prescription drug spending will surpass $400 billion. And it may reach $517 billion by 2017.

With this trend, plan sponsors and employers like you need to contain costs. At the same time, retirees want to know they have prescription drug coverage when they need it. Humana offers a variety of plans that provide the protection and guidance retirees seek.

Pharmacy choices to fit your needs

You want to offer pharmacy coverage, but aren't sure what's available for your budget. With Humana's experience and innovation with pharmacy benefits, we have just what you need.

We offered our first Medicare plan in 1985. Today, we have more than 3.5 million Medicare beneficiaries among our more than 10 million plan members. Humana Pharmacy Solutions is the fifth largest Pharmacy Benefits Manager (PBM).

Take a look. We're sure we have pharmacy benefits that fit your needs and those of your retirees.

Commercial Rx Plan – Retiree Drug Subsidy (RDS)

If you don't want to manage multiple pharmacy plans, you can keep your retirees on the same plan you have for your active employees. The RDS program, created under the Medicare Modernization Act of 2003, gives employers like you incentives to keep Medicare-eligible retirees on a commercial pharmacy plan. Under the program, CMS will reimburse you up to 28 percent of eligible costs. Subsidy is not provided for expenses incurred by members who are also enrolled in a Part D plan.


  • RDS payments are made on actual drug expense
  • Subsidy is currently exempt from federal taxation, but will be taxable in 2013
  • Limited benefit disruption
  • Plan design and drug list flexibility
  • Customizable network, mail order or retail, not restricted by CMS — allows for plan design and drug list flexibility

Medicare Advantage Employer Plan with Prescription Drug Coverage (MAPD) or Prescription Drug Plan (PDP)

Also known as Employer Group Waiver Plans (EGWPs), all of Humana's Medicare plans with prescription drug benefits meet the government's requirements for "creditable coverage" — coverage at least as good as Medicare's basic plan. Prescription drug coverage is available with any Medicare Advantage plan or as a stand-alone plan. Coverage choices range from a standard option with basic Medicare-approved coverage to a higher level of benefits with no coverage gap.


  • CMS reimbursement to help reduce (subsidize) premiums. You won't receive direct payment, so there are no employer tax considerations.
  • No CMS employer contribution requirements.
  • Breaks out the retiree claim experience from the active employee risk pool. That way, both populations can reduce costs.
  • Beneficial GASB/FASB impact—you can reduce your liability for retiree health benefits.
  • You'll pay a set amount each month. That makes it easy to budget for retiree medical costs.

Group Medicare Access Only MAPD

If you don't offer retiree benefits, but want to endorse a health plan for your retirees, a no-employer-contribution option is available (up to a 20 percent contribution still qualifies as access only). With this option, you simply endorse the plan to your retiree base and allow Humana to market it. The policy certificate of coverage is issued to the retiree, who's billed directly for 100 percent of the premium.


  • Humana bills members directly for the premium
  • Minimal administration and no cost to group
  • No employer contribution required
  • Allows you to offer a competitive benefits package with little to no financial risk
  • Helps retirees choose with confidence

Explore your options

Your employees trust you to help them choose benefits—and your retirees are no different. For that reason, we're here to help you choose the right coverage for your needs and your budget.

Talk to your Humana sales agent or broker today and see how we can help.