Humana Value Rx Plan (PDP)

Formulary tiers — preferred pharmacy, initial coverage phase

Cost-sharing by coverage phase

Star rating measures

Benefits in plain text

The following Medicare Prescription Drug plan (PDP) benefits apply to the Humana Value Rx Plan (PDP) (S5884 - 211) in CMS Region 32 , which includes all counties in CA. This plan is administered by Humana Insurance Co. & Humana Insurance Co. of NY, a national plan provider. This means that the insurance carrier offers Medicare Part D plan in most every state. To switch to a different Medicare Prescription Drug plan or to change your location, click here. Click here to see the Humana Value Rx Plan (PDP) prescription drug benefit details in chart format or email and view benefits chart Plan Premium The Humana Value Rx Plan (PDP) has a monthly premium of $104.60. That is $1,255.20 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for extra help , your premium will be lower. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA) . Plan Membership and Plan Ratings The Humana Value Rx Plan (PDP) (S5884 - 211) in CMS Region 32 currently has 40,704 members, and 1,593,904 members in the Humana Value Rx Plan (PDP) nationwide. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3 stars. The detail CMS plan carrier ratings are as follows: Customer Service Rating of 5 out of 5 stars Member Experience Rating of 3 out of 5 stars Drug Cost Information Accuracy Rating of 2 out of 5 stars Prescription Drug Coverage: Deductible, Cost-sharing, Formulary This plan has a $601 deductible. However, formulary drugs on Tier 1 and 2 are excluded from the $601 deductible and have first dollar coverage (or a $0 deductible). So, you are 100% responsible for the first $601 in medication costs for drugs not on the excluded tiers. After you have met the deductible, the Humana Value Rx Plan (PDP) will share the costs of your medications with you (see cost-sharing below). The maximum deductible for 2026 is $615, but this plan (Humana Value Rx Plan (PDP)) has a $601. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible . The following information is about the Humana Value Rx Plan (PDP) formulary (or drug list). There are 3009 drugs on the Humana Value Rx Plan (PDP) formulary. The Humana Value Rx Plan (PDP) does offer a mail order service . Click here to browse the Humana Value Rx Plan (PDP) Formulary . The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $601, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Humana Value Rx Plan (PDP)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows: Tier 1 ( Preferred Generic ) contains 314 drugs and has a co-payment of $0.00 . Tier 2 ( Generic ) contains 613 drugs and has a co-payment of $0.00 . Tier 3 ( Preferred Brand ) contains 584 drugs and has a co-insurance of 18% of the drug cost. Tier 4 ( Non-Preferred Drug ) contains 943 drugs and has a co-insurance of 32% of the drug cost. Tier 5 ( Specialty Tier ) contains 625 drugs and has a co-insurance of 26% of the drug cost. All forms of insulin covered by this Medicare Part D plan will have a copay of $35 or less through all phases of coverage. Please contact the drug plan for more details. Click here to browse the Humana Value Rx Plan (PDP) Formulary .