2016 Medicare Prescription Drug Plan Cost-Sharing Details

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2016 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
Humana Preferred Rx Plan (PDP) (S5884-105-0)
Benefit Details        
This plan is available in CMS PDP Region 11
Monthly Premium: $27.50
Rx Deductible: $360
Initial Coverage Limit: $3,310 Qualifies for LIS: Yes


Click on a letter below to view the
Humana Preferred Rx Plan (PDP) Formulary
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This Plan Uses Lower Cost-Sharing for Preferred Pharmacies
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
Initial Deductible Phase Cost Sharing
All Formulary Drug Tiers: 100% 100% 100% 100% 100% 100%
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic: $1.00 $3.00 $1.00 $3.00 $9.00 $0.00
Tier 2: Generic: $2.00 $5.00 $2.00 $6.00 $15.00 $0.00
Tier 3: Preferred Brand: 20% 25% 20% 20% 25% 15%
Tier 4: Non-Preferred Brand: 35% 42% 35% 35% 42% 30%
Tier 5: Specialty Tier: 25% 25% 25% n/a n/a n/a
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 42% Generic and 55% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 58% 58% 58% 58% 58% 58%
All Formulary Brand-Name Drugs: 45% 45% 45% 45% 45% 45%
Catastrophic Coverage Phase Cost Sharing
Generic & Preferred Multi-Source Drugs: The greater of 5% or $2.95 The greater of 5% or $2.95
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $7.40 The greater of 5% or $7.40
Go to the Humana Preferred Rx Plan (PDP) 2016 Formulary Browser by choosing a letter below:
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