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Humana MAPD vs. PDP: What’s the difference?

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MAPD and stand-alone PDP considerations

Original Medicare doesn’t cover prescription drugs, but few Medicare members would want to go without this valuable coverage. Members who opt for Original Medicare can add a stand-alone Medicare Part D prescription drug plan (PDP) to their Part A (hospital) and Part B (medical) coverage.

Another option is a Medicare Advantage prescription drug plan (MAPD). These plans are required to offer at least all the benefits of Original Medicare Parts A and B and include Rx coverage all in 1 easy-to-use plan.

Humana MAPD vs PDP

Which plan type is right for you?

An all-in-1 MAPD plan

An MAPD may be a good choice for people who are looking for plan options that offer low out-of-pocket costs for premiums, copays and deductibles. MAPD plans may also be right for people who want the additional benefits that MAPD plans may offer, like coverage for routine dental, vision and hearing care.

A standalone PDP

If you travel often to see the grandkids or spend a lot of time away from home, Original Medicare travels with you—but it doesn’t cover prescription drugs. Purchasing a PDP will give you that valuable coverage, but you’ll have to pay a monthly plan premium for it.

Learn more about your options for prescription drug coverage

Medicare Advantage prescription drug plans (MAPD) Standalone prescription drug plan (PDP) Coverage MAPD plans combine hospital, medical and prescription drug coverage all in 1 plan. PDP plans cover prescription drugs only, so a PDP may complement Original Medicare coverage. Costs Most MAPD plans offer an affordable or even $0 monthly plan premium, although members must continue to pay the Medicare Part B premium. ($164.90 in 2023). CMS projects the average basic monthly plan premium for a Medicare Part D plan in 2023 to be $31.50. Members must continue to pay the Medicare Part B premium ($164.90 in 2023). Choice Humana MAPD plans include HMOs (health maintenance organizations), PPOs (preferred provider organizations), SNPs (Special Needs Plans) and PFFS (private fee-for-service) plans types. Humana offers 3 PDP drug plans to support a variety of health needs and budgets: Humana Walmart Value Rx plan, Humana Premier Rx plan and Humana Basic Rx plan. Coverage, costs and drugs covered vary by plan choice and location. Added benefits Most MAPD plans include coverage for routine dental, vision and hearing care. Some provide supplemental benefits like spending allowances, transportation, fitness club memberships or Medicare Part B givebacks. PDP coverage is limited to coverage for prescription drugs. New for 2023 Enjoy enhanced benefits such as $0 vaccines and $35 insulin benefits with Humana’s 2023 MAPD plans. Humana’s Premier Rx Plan (PDP) offers an even lower copayment on Select Insulins, PDF opens new window for eligible members—$25 or less for a 30-day supply at preferred network pharmacies. Pharmacy networks Humana’s network includes more than 67,000 pharmacies including CenterWell Pharmacy™, Walmart, Walmart Neighborhood Markets, Sam’s Club, Publix, Harris Teeter, H-E-B, Costco pharmacies and the Albertsons Companies family of pharmacies. Humana’s PDP networks also include preferred cost sharing at CenterWell Pharmacy™ and Walmart pharmacies, where members may save even more.

However you choose to get Rx coverage, you can choose Humana with confidence

For the second year in a row, Humana overall received the highest performance rating for providing transparent prices, rates and fees among health insurers in Forrester’s proprietary 2022 Customer Experience Benchmark survey.1

We’re proud to say that 96% of Humana’s 2023 Medicare Advantage (MA) members are in plans rated 4 out of 5 stars or higher by the Centers for Medicare and Medicaid (CMS).2

Show me my plan options so I can choose the type of coverage I need

Not sure where to start? Check out our plan options and get recommendations based on your needs. Keep in mind that Medicare Advantage plans may include coverage for prescription drugs and routine dental, vision and hearing care—all in 1 easy-to-manage plan.

Learn more

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Sources

  1. Humana received the highest CX Index™ score among health insurers in Forrester’s proprietary 2022 CX Index™ survey. The ranking was based on responses from 12,985 US individuals measuring 17 brands in the industry. The proprietary survey results are based on consumers’ opinions of the experiences with the brands in the survey. Forrester Research does not endorse any company included in any CX Index™ report and does not advise any person to select the products or services of any particular company based on the ratings included in such reports.

  2. “96% of Humana’s Medicare Advantage Members are in Contracts rated 4-Star or Above for 2023; 66% are in Contracts Rated 4.5-Stars or Higher,” Humana Inc., last accessed October 13, 2022, https://humana.gcs-web.com/news-releases/news-release-details/96-humanas-medicare-advantage-members-are-contracts-rated-4-star