Humana Premier Rx Plan (PDP)

Humana Inc.
Humana Premier Rx Plan (PDP) S5884-169 Plan Details
3 out of 5 stars

Humana Premier Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-169.

$72.90
Monthly Premium

Humana Premier Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-169.

Humana Inc.
Humana Premier Rx Plan (PDP) S5884-169 Plan Details
3 out of 5 stars

Humana Premier Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-169.

$72.90
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $300
Out of Pocket Max In-Network: $-1
Out-of-Network: N/A
Initial Coverage Limit $4660
Catastrophic Coverage Limit $7,400

Prescription Drug Costs and Coverage

The Humana Premier Rx Plan (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $300 (excludes Tiers 1 and 2) per year.

Coverage
Cost
Coverage & Cost
Annual Drug Deductible $300 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $1.00
  • Standard retail $5.00
  • Preferred cost-share mail order $1.00
  • Standard mail order $5.00
Generic
  • Preferred cost-share retail $4.00
  • Standard retail $10.00
  • Preferred cost-share mail order $4.00
  • Standard mail order $10.00
Annual Drug Deductible $300 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail N/A
  • Standard retail N/A
  • Preferred cost-share mail order N/A
  • Standard mail order N/A
Generic
  • Preferred cost-share retail N/A
  • Standard retail N/A
  • Preferred cost-share mail order N/A
  • Standard mail order N/A
Annual Drug Deductible $300 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $3.00
  • Standard retail $15.00
  • Preferred cost-share mail order $0.00
  • Standard mail order $15.00
Generic
  • Preferred cost-share retail $12.00
  • Standard retail $30.00
  • Preferred cost-share mail order $0.00
  • Standard mail order $30.00