Humana Walmart-Preferred Rx Plan, MS 2013 PDP

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Summary Rating:This Medicare drug plan has an average rating of 3.0
Premium:
$18.50
Deductible:$325.00
Initial Coverage Limit:$2,970.00
Mail Order:Yes
Gap Coverage:No Gap Coverage
$0 Premium LIS Benefit:Yes
Drugs in Formulary:3100
Drug Plan ID:S5884-142
Plan Year:2013
CMS Approved for:MS Residents
Plan Type:National
Members in Region:17389

PDP Plan Highlights

Healthy Mississippi Senior, Medicare Part D Plan: Humana Walmart-Preferred Rx Plan (PDP) S5884-142MS 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 AmountMedications in Tier
1$1.00258 Preferred Generics
2$5.001044 Non-Preferred Generics
320%885 Preferred Brand Drugs
435%913 Non-Preferred Brand Drugs
50 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.

Plan Members

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

Pharmacy arrangements are different with every drug program. Certain plans have strict regional restrictions, that include state boundaries, while some supply national drugstore coverage. If you have an active lifestyle which includes regular traveling, it's going to help you to have a policy that allows you to utilize pharmacies in all states.

Medicare Part D plans have got a specified service area. This is basically the area in which the provider does business. To enroll, you will need to live in the plan’s provider area. Be aware that nearly all providers provide mail-order solutions. Therefore you could have your pharmaceuticals mailed directly to your residence. Your agent can help you look for a program that meets your requirements, so don’t be reluctant to simply call and ask.

Each medical insurance provider sets their own rates. Prices for approved drug plans can vary quite a bit, even to get similar coverage, therefore it will pay you to look before you choose.

Insurance providers announce new fees along with other premium information each October. You'll want to take a look at and assess rates annually prior to open enrollment.

Please remember if you don't register for a Medicare Part D insurance plan when you first are eligible, your long term monthly premiums will likely be higher. This late entry penalty is established by Medicare, not the insurance companies. Each month you wait after eligibility you will pay an additional 1% every month forever.