*Premium varies by state or region. Please refer to the Summary of Benefits and Coverage for your state for additional information.
**If you don't live in an area where preferred cost-sharing pharmacies are close to you, your ability to take advantage of this benefit will be limited. In some areas, preferred cost-sharing pharmacies may be extremely limited.
**If you don't live in an area where preferred cost-sharing pharmacies are close to you, your ability to take advantage of this benefit will be limited. In some areas, preferred cost-sharing pharmacies may be extremely limited.
How drug tiers work
Some plans group their formulary, or Drug List, into tiers. Tiers help determine the amount you’ll pay for your prescription. Typically, drugs in lower tiers cost less than those in higher tiers.
Tier 1 – Preferred generics - usually includes more common, lower cost, generic prescription drugs
Tier 2 – Generics - usually includes higher cost generic prescription drugs and some lower cost brand prescription drugs
Tier 3 – Preferred brand - brand name drugs that don't have a generic equivalent
Tier 4 – Nonpreferred drug - higher-priced brand and generic drugs with no preferred cost share
Tier 5 – Specialty Tier - the most expensive drugs, usually used to treat complex conditions like cancer, multiple sclerosis or rheumatoid arthritis
If you're currently taking prescription medication, you can use our search tool to look up a specific drug. It will tell you if the drug is covered by Humana and which tier it's listed under. It may also offer alternatives and generics that might save you money.
Get help managing your medications
If you’re taking a number of medications prescribed by more than one doctor, you may be eligible to take advantage of Medication Therapy Management (MTM). Through this program, you can meet one-on-one with a doctor or pharmacist to learn more about your medicines and how they work, ask questions about side effects or interactions with other medications and look for opportunities to lower your costs.
Good things to know before you shop
- If you opt for Original Medicare, a PDP could be a great addition, as Original Medicare doesn’t provide prescription drug coverage. For even more protection against high healthcare costs on Original Medicare, you can pair a PDP with a Medicare Supplement insurance plan.
- If you don’t sign up for a prescription drug plan when you’re first eligible and you don’t have other creditable drug coverage, you’ll likely pay a late enrollment penalty if you join later, and you’ll continue to pay that penalty each month for as long as you have your plan.
- Already taking one or more prescription drugs? Resist the urge to shop based on premium alone. Consider the deductibles (the amount you pay for prescription drugs before your plan begins to pay) and the copays (a set dollar amount you pay for each prescription you fill). Some plans have a $0 deductible and $0 copays on certain drug tiers, which can add up to real savings over time.