Humana Preferred Rx Plan for Maine is a 2019 prescription drug plan (PDP) that's available to seniors on Medicare.
The Centers for Medicare & Medicaid Services (CMS) evaluated this Medicare Part D plan's previous year performance and rated it 3.5 out of 5 stars (Average) for quality.
These are the areas of the plan that are important to compare and review:
- Premium & Deductible: The premium is the amount you will pay monthly. Plud, many plans have an annual deductible that must be met before cost sharing begins.
- Coverage Phases: Part D plans have an initial coverage limit, followed by a coverage gap, and then catastropic coverage. Some plans offer some coverage in the gap.
- Co-pays & Co-insurance: If you have regular prescriptions, it's critical to verify that your drugs are covered and to know what you will pay at the pharmacy.
- CMS Ratings: Important measurements across 4 different areas that will help you understand how well this plan will care for you.
Humana Preferred Rx Plan is a cost sharing prescription drug plan (PDP). There are three distinct costs: monthly premiums, an annual deductible, and co-payments or co-insurance.
The annual premium on this PDP is $406.80 ($33.90 per month), and breaks down as follows:
This plan qualifies for the full, low income subsidy benefit. The following table details subsidised premium amounts:
|Subsidy Level||Monthly Premium|
There is a $415.00 annual deductible with this PDP.
For 2019, the maximum Part D deductible in is $415. 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 Pay the Premium + Deductible + Copayments
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.
What You Pay Could Be Different
There are two situations that can change your monthly premium. If your income is low and you are accepted into the Extra Help program administered by Social Security, your premium could be lower. It's also possible that your premium could be higher due to a late entry penalty. Be sure to speak with an authorized Maine Medicare Insurance Agent to get an exact quote for your situation.
Humana Preferred Rx Plan is a Basic PDP. At a minimum, Humana Insurance Company must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:
- are actuarially equivalent to the standard benefit; or
- are enhanced, offering benefits in addition to the standard benefit.
Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.
Initial Coverage Limit
The ICL is the same for all Maine plans, but it changes from year-to-year. If you enroll in Humana Preferred Rx Plan you share the cost of all covered medications with Humana Insurance Company. You each pay your share until $3820.00 (retail spending) has been spent at the pharmacy. If you reach that level of spending on your prescriptions then you fall into the dreaded coverage gap and you are responsible for all costs. Fortunately, automatic discounts kick in to help you until you qualify for Medicare's catastrophic coverage in Maine.
Coverage Gap (aka, Donut Hole)
The coverage gap, or donut hole, as it is often called, is the coverage phase where you no longer receive assistance from the plan. In other words, you pay for your prescriptions out-of-pocket. How quickly you reach the coverage gap with Humana Preferred Rx Plan all depends on your prescriptions. Most seniors never fall into the donut hole.
In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $4,550 (excluding premiums and expense paid by insurance) minus a 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs. Once you reach $4,550 in out-of-pocket expenses, you're out of the coverage gap. At this point you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.
Additional Gap Coverage
Humana Preferred Rx Plan does not offer additional assistance in the coverage gap. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Maine 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 Preferred Rx Plan prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:
|1 (Preferred Generic)||$0.00 copay|
|2 (Generic)||$1.00 copay|
|3 (Preferred Brand)||25%|
|4 (Non-Preferred Drug)||36%|
|5 (Specialty Tier)||25%|
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you lookup your prescriptions in the plan's formulary.
Medicare Part D Star Ratings
In this section we show you the quality rating for this plan. Each year the Centers for Medicare and Medicaid Services (CMS) rates prescription drug plans in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this Humana Insurance Company plan.
Contact Humana Insurance Company
Here's the new member contact information for Humana Insurance Company:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part D program on www.medicare.gov or the Wikipedia page. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the Humana Preferred 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 Portland, Lewiston, Bangor, South Portland, Auburn, Biddeford, Sanford, and all other towns and cities in Maine.
The Medicare Part D plan data on MedicareWire.com originates from CMS.gov Landscape Source files and is subject to change. The Centers for Medicare and Medicaid Services has neither reviewed nor endorsed the information on this site.
The benefit information provided on this page is a brief summary only, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly at (800)706-0872 or (711)- for TTY users.
You must live in the service area and be enrolled in Medicare Part A and/or Medicare Part B in order to enroll in a Medicare Part D plan.
You must use network pharmacies to access drug benefit, except in non-routine circumstances. Restrictions may apply.
Benefits, formulary, pharmacy network, premium, and/or co-payments/co-insurance may change January 1, of each year.
This page presents an independent review of Humana Insurance Company as a Medicare Part D plan insurance carrier in Maine. MedicareWire provides this information for consumer educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information about each carrier. MedicareWire is not a substitute for legal, health, or financial advice from a licensed professional.
On this page we help comsumers:
Compare Humana Preferred Rx Plan, a Medicare Part D Plan available in Maine for $33.90/month with a $415.00 annual deductible, with all 2019 Medicare Prescription Drug Plans in ME. Find the best PDP plan for the medications you take and start saving.
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This page is maintained by David Bynon and was last updated on .