Humana Walmart Value Rx Plan™ prescription costs

Annual deductible: $0 for Tiers 1 and 2, $435 for Tiers 3, 4 and 5
Walmart, Walmart Neighborhood Markets, and Sam’s Club preferred retail network pharmacy cost sharing (30-day supply*) All other retail network pharmacies cost sharing (30-day supply*) Humana Pharmacy preferred mail-delivery pharmacy cost sharing (90-day supply) Tier 1
Preferred Generic
$1 copay $10 copay $3 copay
Tier 2
$4 copay $20 copay $12 copay
Tier 3
Preferred Brand
$47 copay $47 copay $141 copay
Tier 4
Non-Preferred Drug
35% coinsurance 50% coinsurance 35% coinsurance
Tier 5
Specialty Drug
25% coinsurance 25% coinsurance 90-day supply not available for Tier 5 medications

*90-day supplies are available for most drugs on Tiers 1–4 (subject to quantity limits); copay is 3 times the 30-day copay.

Be sure to check the Drug List to find your medication’s tiers and choose a plan based on those costs. You’re not required to have a prescription drug plan, but you may face a late enrollment penalty for not enrolling when you’re first eligible for Medicare.