Understanding medicare drug plan

Understanding the Medicare prescription drug plan

Things to consider when choosing prescription benefit coverage

A Medicare prescription drug plan can give you some relief from the high cost of medications, but all this new information can be hard to understand. It's natural that you might want some help sorting it all out. If you're considering a Medicare prescription drug plan, please keep the following issues in mind.

Facts about Medicare prescription drug plan enrollment

  • If you purchase a stand-alone Medicare prescription drug plan while you're enrolled in a Medicare Advantage plan with prescription drug coverage (MAPD), you'll be automatically disenrolled from the MAPD plan.
  • A Medicare prescription drug plan is an option, not a requirement. You do not have to enroll in Medicare Part D. However, even if you do not take many prescription drugs now, you may want to enroll in a plan so you’ll have it if you need prescription drug coverage in the future.
  • Be aware that you could face a late enrollment penalty if you do not enroll in a  Medicare prescription drug plan when you’re initially eligible for Medicare, or if you go without prescription drug coverage that covers as much or more than a Medicare drug plan for more than 63 continuous days after you’re eligible.

Medicare prescription drug plan eligibility requirements

  • To enroll in a Medicare prescription drug plan, you have to meet eligibility requirements.
  • If you're entitled to Part A and/or enrolled in Part B of Original Medicare and live in the service area, you're eligible to join.

Medicare prescription drug plan benefits vary

  • Stand-alone Medicare prescription drug plans have a monthly premium in addition to any Medicare premium you already pay.
  • If you need coverage for prescription drugs and doctor and hospital visits, you should consider purchasing a Medicare Advantage plan. A Medicare Advantage plan (including most of Humana's plans) may be able to provide you with doctor and hospital coverage and prescription drug coverage all for one plan premium. Explore Humana's all-in-one Medicare Advantage plans.
  • Humana's prescription drug plan benefits are equal to, or better than, Medicare's required minimum.

When you enroll affects your effective date and premium

  • In most cases, your coverage becomes effective on the first day of the next month after you join. If you are enrolling close to the end of the month, we recommend enrolling here on our website or by phone.
  • You may have to pay more each month if you didn’t enroll in a Medicare prescription drug plan when you were initially eligible for Medicare and don’t have a drug plan that covers as much or more than a Medicare drug plan. This late enrollment penalty may be at least 1% more (of the national average premium) for every month you go without prescription drug coverage.

Humana's prescription drug plans deliver more than drug coverage

When you enroll in a Humana prescription drug plan, you gain access to guidance, support, and convenience through things like:

  • MyHumana — yyour secure account where you can track your personal and family health insurance benefits, budget for your medical expenses, and find ways to save on healthcare. It’s for members who already have a Humana plan. Take a tour now
  • Maximize Your BenefitSM Rx — a Humana Pharmacy Solutions® program that lets you know about potential savings opportunities for high-cost medications. Find out more about Maximize Your Benefit Rx
  • SmartSummary Rx® — a personalized statement that sums up your prescription drug spending and benefits any month after the month in which you have a claim. Learn more about SmartSummary Rx

If you need drug coverage AND health coverage — Explore Humana's all-in-one Medicare Advantage plans.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premium and/or member cost-share may change on January 1 of each year.

Other pharmacies are available in our network.

  • Humana’s pharmacy network offers limited access to pharmacies with preferred cost sharing in urban areas of AL, AR, CA, CT, DC, DE, GA, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV; WY; suburban areas of AZ, CA, CT, DC, DE, HI, IA, IL, IN, MA, MD, ME, MI, MN, MO, MT, ND, NH, NE, NJ, NY, OH, OR, PA, PR, RI, SD, VT, WA, WV, WY; and rural areas of AK, DC, 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: CT, DE, MA, MD, ME, MI, MN, MS, NC, ND, NY, OH, RI, 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.
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