Humana Walmart Value Rx Plan 2020 Maine Medicare Part D Plan S5884-181

On this page we help consumers: Compare Humana Walmart Value Rx Plan, a 2020 Medicare Prescription Drug Plan (PDP) available in Maine for $13.20/month with a $435.00 deductible, with all Medicare Part D Plans in ME.

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.

Cost Details

Humana Walmart Value 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.

Premium

The annual premium on this PDP is $158.40 ($13.20 per month), and breaks down as follows:

Basic Premium:	$6.90
Supplemental Premium:	$6.30
Full Premium:	$13.20

Low-Income Subsidy

This plan is not available to people receiving full Low Income Subsidy (LIS) benefits.

Deductible

There is a $435.00 annual deductible with this PDP.

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

Be aware that you must continue to pay your monthly premium even when you are not using any medications. Also, it's important to plan ahead because you are responsible for one hundred percent of your prescription costs until the plan's deductible has been met. You also make the required copayment when you pickup your prescriptions. These are your share of the prescription drug costs. The plan pays the rest until you reach the coverage gap (aka, “donut hole”).

What You Pay Could Be Different

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 Maine Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

Humana Walmart Value Rx Plan is a Enhanced 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 Walmart Value Rx Plan you share the cost of all covered medications with Humana Insurance Company. You each pay your share until $4020.00 (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)

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 (75% off of both brand-name drugs and generics). You continue to pay this until your out-of-pocket costs reach $6,350. 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

Humana Walmart Value 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 Walmart Value 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:

Tier	Preferred	Standard
1 (Preferred Generic)	$1.00 copay	$10.00 copay
2 (Generic)	$4.00 copay	$20.00 copay
3 (Preferred Brand)	$47.00 copay	$47.00 copay
4 (Non-Preferred Drug)	35%	50%
5 (Specialty Tier)	25%	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:

Prospective Members:	(800)706-0872
TTY Users:	(711)-
Plan Website:	http://www.humana.com/medicare
Formulay Information:	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/
Pharmacy Information:	http://www.humana.com/medicare/medicare_prescription_drugs/

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.

Availability

If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the Humana Walmart Value 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 information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on October 2, 2019.