Humana Walmart Value Rx Plan (PDP)

Humana Inc.
Humana Walmart Value Rx Plan (PDP) S5884-204 Plan Details
3 out of 5 stars

Humana Walmart Value Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-204.

$30.50
Monthly Premium

Humana Walmart Value Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-204.

Humana Inc.
Humana Walmart Value Rx Plan (PDP) S5884-204 Plan Details
3 out of 5 stars

Humana Walmart Value Rx Plan (PDP) is a plan offered by Humana Inc..
Plan ID: S5884-204.

$30.50
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $505
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 Walmart Value Rx Plan (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $505 (excludes Tiers 1 and 2) per year.

Coverage
Cost
Coverage & Cost
Annual Drug Deductible $505 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $10.00
  • Preferred cost-share mail order $0.00
  • Standard mail order $10.00
Generic
  • Preferred cost-share retail $2.00
  • Standard retail $20.00
  • Preferred cost-share mail order $2.00
  • Standard mail order $20.00
Annual Drug Deductible $505 (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 $505 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $30.00
  • Preferred cost-share mail order $0.00
  • Standard mail order $30.00
Generic
  • Preferred cost-share retail $6.00
  • Standard retail $60.00
  • Preferred cost-share mail order $6.00
  • Standard mail order $60.00