Humana Walmart-Preferred Rx Plan, MS 2013 PDP
|Initial Coverage Limit:||$2,970.00|
|Gap Coverage:||No Gap Coverage|
|$0 Premium LIS Benefit:||Yes|
|Drugs in Formulary:||3100|
|Drug Plan ID:||S5884-142|
|CMS Approved for:||MS Residents|
|Members in Region:||17389|
PDP Plan Highlights
MS Humana Walmart-Preferred Rx (PDP) is an approved Mississippi Medicare Part D Plan. The Humana Insurance Company plan is based on formulary 00012265 with 3100 drugs approved by the FDA. The annual premium is $222.00 ($18.50 monthly), and it carries a $325.00 deductible on all prescribed medications. The maximum deductible for 2013 is $325. This is regulated by CMS.
Mississippi seniors, several factors may increase or decrease this premium. For example, if you qualify for full or partial Extra Help, your premium could be lower. If you have a premium penalty (for late entry), your premium will be higher.
Humana Walmart-Preferred Rx Plan Initial Coverage Phase
The Initial Coverage Phase (ICP) is your plan’s cost-sharing phase. During the ICP both you and your insurance provider share the cost of your prescription medications. This plan has a deductible, so your ICP does not start until the deductible has been paid.
Each medication is put into a tier within the plan’s formulary. This is simply a way for the insurer to manage cost-sharing. It’s important to note that every plan can put medications on any tier they deem suitable. This is not standardized, because it is based on cost and the various risk models used by the insurers.
If you choose Humana Walmart-Preferred Rx (PDP) your pharmacy co-pay in Mississippi will be tiered as follows:
|Tier||Co-Pay Amount||Medications in Tier|
|1||$1.00||258 Preferred Generics|
|2||$5.00||1044 Non-Preferred Generics|
|3||20%||885 Preferred Brand Drugs|
|4||35%||913 Non-Preferred Brand Drugs|
|5||0 Specialty Drugs|
The Initial Coverage Limit (ICL) is $2,970.00. This policy does qualify for the full LIS benefit ($0.00 monthly premium).
Coverage Gap Phase
The Coverage Gap, also known as the Donut Hole is the phase of your Part D plan where you must pay all of your medication costs. Healthcare Reform offers some additional assistance. For 2012 your insurance carrier will pay 7% of your generic drug prescription costs for you while you are in the donut hole. Likewise, the brand-name drug pharmaceutical companies cover half (50%) of your brand-name drug prescription costs. These subsidies count toward your True Out of Pocket (TrOOP) costs.
Some Medicare Part D plans provide additional Coverage Gap assistance that covers you above and beyond the discounts mandated by the Healthcare Reform Act. It’s important to note that if you have prescriptions that are not covered under your plan’s Gap Coverage, you will still get the generic and brand name drug discounts listed above, even if the plan itself does not offer gap coverage.
The Gap Coverage with this policy: You must pay the $3727.50.
Nation wide, the number of seniors using the Humana Walmart-Preferred Rx Plan policy is 1,412,142. In region 20 (your region) there are approximately 17,389 people with this policy (based on 2011 CMS statistics).
Facts About Humana Insurance Company
Humana Inc., headquartered in Louisville, Kentucky, is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Essential Information About Medicare Part D
Pharmacist arrangements will vary with every prescription drug plan. Certain plans have strict geographic limits, including state boundaries, while some give national drugstore coverage. For those who have an active personal life which consists of frequent traveling, it's going to benefit you to have a policy that permits you to utilize pharmacies in all states.
Medicare Part D plans have got a designated service area. This is the area where the provider does business. To sign up, you must reside in the plan’s provider area. Be aware that many providers provide mail-order services. Therefore you could have your medications mailed directly to your house. Your representative can help you find a plan that meets your needs, so don’t hesitate to phone and inquire.
Each medical insurance supplier sets their own prices. Payments for approved drug plans can vary quite a bit, even to get identical coverage, as a result it will pay you to shop before you choose.
Insurance providers publicize new fees as well as other premium information each October. Be sure to check and assess rates annually in advance of open enrollment.
Please remember if you don't sign up for a Medicare Part D policy once you first are eligible, your future rates will probably be higher. This late entry penalty is set by Medicare, not the insurance plan providers. Every month you postpone after eligibility you'll pay an extra 1% per month forever.