Humana Walmart Rx Plan for Arizona is a Medicare Part D prescription drug plan. It's approved by the Centers for Medicare and Medcaid Services (CMS) for people in Arizona with Medicare benefits. CMS gave it a quality rating of out of 5.0 stars ("Above Average").
If you enroll in this plan you'll pay the $15.70 monthly premium, and there's a $320.00 annual deductible before cost sharing begins. For more information about the costs, refer to the premium page. You can check out the coverage information on the coverage page, or click on the copayments page to see your costs at the pharmacy.
This plan is not available to people receiving low income subsidy (LIS) benefits.
Like all Medicare Part D plans sold in Arizona, Humana Walmart Rx Plan is a cost sharing based prescription drug plan (PDP). If you enroll in the Humana Walmart Rx Plan PDP, you share in the overall costs with the insurer by paying a monthly premium, an annual deductible (if applicable), and copayments at your pharmacy.
The premium on this plan is $188.40 ($15.70 per month). It comes with a $320.00 annual deductible. For 2015, the maximum Part D deductible is $320. A plan with the maximum deductible does not necessarily mean that it is more expensive than a plan with a lower deductible or no deductible at all. You need to consider all costs.
You are required to pay your premium each month, even if you don't fill a prescription. Plus, you'll pay all of your prescription costs until the annual deductible amount has been paid (if any). You'll also pay the required copayment at your pharmacy when you have your prescriptions filled. These are your costs and the plan pays the rest.
For all seniors on Medicare, there are two conditions that could affect how much you pay for this plan. If you qualify for the Social Security Extra Help program your premium will generally be lower. Also, if you enrolled late the Centers for Medicare and Medicaid Service may impose a premium penalty. Contact your local Arizona Medicare Insurance Agent to get an exact quote for your situation.
Humana Walmart Rx Plan for Arizona seniors comes with an initial coverage limit (ICL) of $2,960. The deductible on this plan is $320.00 (annual). ICL is calculated based on the full retail cost of prescriptions, not what you or the plan pays. When you pick up your prescriptions you will need to make a co-payment. The co-payments page will show you your share at the pharmacy with this plan.
This prescription drug plan has a $320.00 deductible that must be paid before the ICP cost-sharing phase begins. The highest deductible Medicare allows is $320. This figure goes down a few dollars each year.
Humana Walmart Rx Plan Initial Coverage Limit
It's important to understand the initial coverage limit (ICL) and how it applies to you in Arizona. The ICL is where you share the cost of your prescriptions with the insurance company. You and the carrier (Humana Insurance Company) each pay your share until you reach a total of $2,960 spent at the pharmacy on prescriptions. At that point you pay all costs yourself because you're in the coverage gap, as explained below.
Medicare Part D Coverage Gap (Donut Hole)
When you fall into the coverage gap, or donut hole as many people call it, you are basically uninsured and must pay for all of your prescription costs out-of-pocket. When you reach the coverage gap will all depend on your prescriptions. Most seniors never exceed the ICL and don't have to worry about it. If you are on a long-term medication that's costly, you could reach the donut hole very quickly.
When you're in the donut hole you pay all of the costs for your medications, but at a discounted rate (47.5% off of brand-name drugs and 28% off generics). You continue to pay this until your out-of-pocket costs reach $4,550. At this point Medicare takes over by giving you catastrophic coverage. The $4,550 out-of-pocket figure does not include your monthly premiums or what Humana Insurance Company pays.
Additional Gap Coverage with Humana Walmart Rx Plan
Some plans offer additional gap coverage. Humana Insurance Company does not offer additional coverage with the Humana Walmart Rx Plan PDP in Arizona. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Arizona Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.
Copayment & Coinsurance Details
In addition to the monthly premium and annual deductible, the Humana Walmart Rx Plan prescription drug plan has copayments and/or coinsurances that you must pay when you pickup your medications. Here's the schedule for this plan:
|Tier||Co-Pay Amount||Medications in Tier|
|1||$1.00||198 Preferred Generics|
|2||$4.00||705 Non-Preferred Generics|
|3||20%||789 Preferred Brand Drugs|
|4||35%||1150 Non-Preferred Brand Drugs|
|5||25%||384 Specialty Drugs|
The Humana Walmart Rx Plan Medicare Part D plan uses Humana Insurance Company formulary number 00015081, which covers 3226 generic and brand name drugs.
Compare this plan with these Arizona PDPs:
- Blue MedicareRx Enhanced PDP for Arizona
- United American - Essential PDP for Arizona
- SilverScript Plus PDP for Arizona
- First Health Part D Premier Plus PDP for Arizona
- Aetna Medicare Rx Saver PDP for Arizona
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the Humana Walmart Rx Plan prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Scottsdale, Phoenix, Peoria, Surprise, Mesa, Tucson, Tempe, Yuma, Avondale, Buckeye, Chandler, Goodyear, Gilbert, Lake Havasu City, Flagstaff, Bullhead City and all other towns and cities in Arizona.
This catalog is maintained by 9/13/2015. CMS File Date: October 15, 2014.and was last updated on
About Humana Insurance Company
For more information, download the Summary of Benefits , visit the Humana Insurance Company website, or call Humana Insurance Company at N/A.