On this page we help consumers: Compare Humana Basic Rx Plan, a 2020 Medicare Prescription Drug Plan (PDP) available in Tennessee for $30.00/month with a $435.00 deductible, with all Medicare Part D Plans in TN.
Humana Basic Rx Plan is a 3.0 Star Medicare Part D Plan for Medicare Beneficiaries in Tennessee
The Centers for Medicare & Medicaid Services (CMS) evaluated this Medicare Part D plan's previous year performance and rated it 3.0 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.
This is a cost sharing based prescription drug plan (PDP). With the Humana Basic Rx Plan PDP you have several different costs, including the premium (monthly), a deductible (annual), and pharmacy co-pays and/or co-insurance.
The monthly premium is $30.00 ($360.00 paid annually). It 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|
The annual deductible is $435.00.
For 2020, the maximum Part D deductible is $435. 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
Most people pay the standard premium. However, if you qualify for Extra Help with your Medicare Part D plan due to your income, your premium may be lower or cost you nothing at all. But, if you did not enroll in a Part D plan as soon as you were first eligible, Medicare can impose a penalty and your premium will be higher. To get an exact rate for your situation, contact a Tennessee Medicare Insurance Agent.
Humana Basic 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
It's important to understand the initial coverage limit (ICL) and how it applies to you in Tennessee. The ICL is where you share the cost of your prescriptions with the insurance company. You and Humana Insurance Company each pay your share until you reach a total of $4020.00 (retail spending) spent at the pharmacy on prescriptions. At that point, you pay all costs yourself because you're in the coverage gap, as explained below.
Coverage Gap (aka, Donut Hole)
When you reach the coverage gap, commonly called the donut hole, you pay for your medications yourself. Most seniors never go into the coverage gap, but it is possible to hit it quickly if you have expensive long-term prescriptions.
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 $6,350 (excluding premiums and expense paid by insurance) minus a 75% discount on both brand-name prescription drugs and generics. Once you reach $6,350 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 Basic 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 Tennessee 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 Basic 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)||N/A||$0.00 copay|
|2 (Generic)||N/A||$1.00 copay|
|3 (Preferred Brand)||N/A||25%|
|4 (Non-Preferred Drug)||N/A||40%|
|5 (Specialty Tier)||N/A||25%|
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you look up 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.
|2020 Overall Rating|
|Drug Plan Customer Service|
|Complaints and Changes in the Drug Plan|
|Member Experience with the Drug Plan|
|Drug Safety and Accuracy of Drug Pricing|
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.
This stand-alone Medicare Part D plan is compatible with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and all Tennessee Medigap plans. It's also compatible with Medicare Part C plans in Tennessee, so long as the plan does not include prescription drug coverage.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the Humana Basic 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 Nashville, Murfreesboro, Memphis, Knoxville, Chattanooga, Clarksville, Jackson, Johnson City, Franklin, Hendersonville, Kingsport, and all other towns and cities in Tennessee.