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Humana Enhanced (PDP) (S5884-001-0)
Tier 1 (206)
Tier 2 (606)
Tier 3 (711)
Tier 4 (1175)
Tier 5 (593)
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
  *required
 
Cick on the first letter of your drug name to browse the formulary:

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2019 Medicare Part D Plan Formulary Information
Humana Enhanced (PDP) (S5884-001-0)
Benefit Details           
The Humana Enhanced (PDP) (S5884-001-0)
Formulary Drugs Starting with the Letter V

in CMS PDP Region 12 which includes: AL TN
Plan Monthly Premium: $76.40 Deductible: $0 Qualifies for LIS: No
Drugs Starting with Letter V

Drug Name
Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
VALACYCLOVIR HCL 1 GRAM TABLET   3 Preferred Brand $47.00$116.00Q:90
/30Days
VALACYCLOVIR HCL 500 MG TABLET   3 Preferred Brand $47.00$116.00Q:90
/30Days
VALCHLOR 0.016% GEL   5 Specialty Tier 33%N/AP Q:60
/28Days
VALGANCICLOVIR 450 MG TABLET [Valcyte]   5 Specialty Tier 33%N/AQ:120
/30Days
VALGANCICLOVIR HCL 50 MG/ML [Valcyte]   5 Specialty Tier 33%N/AQ:1056
/30Days
VALPROIC ACID 250 MG CAPSULE [Depakene]   2 Generic $10.00$0.00None
VALPROIC ACID 250 MG/5 ML SOLN Solution [Depakene]   2 Generic $10.00$0.00None
VALSARTAN 160 MG TABLET [Diovan]   2 Generic $10.00$0.00Q:60
/30Days
VALSARTAN 320 MG TABLET [Diovan]   2 Generic $10.00$0.00Q:60
/30Days
VALSARTAN 40 MG TABLET [Diovan]   2 Generic $10.00$0.00Q:60
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VALSARTAN 80 MG TABLET [Diovan]   2 Generic $10.00$0.00Q:60
/30Days
VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT]   1 Preferred Generic $5.00$0.00Q:30
/30Days
VALSARTAN-HCTZ 160-25 MG TAB [Diovan HCT]   1 Preferred Generic $5.00$0.00Q:30
/30Days
VALSARTAN-HCTZ 320-12.5 MG TAB [Diovan HCT]   1 Preferred Generic $5.00$0.00Q:30
/30Days
VALSARTAN-HCTZ 320-25 MG TAB [Diovan HCT]   1 Preferred Generic $5.00$0.00Q:30
/30Days
VALSARTAN-HCTZ 80-12.5 MG Tablet [Diovan HCT]   1 Preferred Generic $5.00$0.00Q:30
/30Days
VANCOMYCIN 500 MG VIAL   4 Non-Preferred Drug 50%44%None
VANCOMYCIN HCL 125 MG CAPSULE   4 Non-Preferred Drug 50%44%Q:120
/30Days
VANCOMYCIN HCL 250 MG CAPSULE   5 Specialty Tier 33%N/AQ:240
/30Days
VANCOMYCIN HCL 250 MG VIAL   4 Non-Preferred Drug 50%44%None
VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE )   4 Non-Preferred Drug 50%44%None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA   4 Non-Preferred Drug 50%44%None
VAQTA 25 UNITS/0.5 ML SYRINGE   4 Non-Preferred Drug 50%44%None
VAQTA 50 UNITS/ML SYRINGE   4 Non-Preferred Drug 50%44%None
Vaqta Hepatitis A Vaccine Adult 50 Unit / mL Injection Single Dose Vial 1 mL   4 Non-Preferred Drug 50%44%None
Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL   4 Non-Preferred Drug 50%44%None
VARIVAX VACCINE W/DILUENT   3 Preferred Brand $47.00$116.00None
VASCEPA 0.5 GM CAPSULE   4 Non-Preferred Drug 50%44%Q:240
/30Days
VASCEPA 1 GM CAPSULE   4 Non-Preferred Drug 50%44%Q:120
/30Days
VELIVET 28 DAY TABLET [Velivet]   4 Non-Preferred Drug 50%44%None
VENCLEXTA 10 MG TABLET   4 Non-Preferred Drug 50%44%P Q:28
/28Days
VENCLEXTA 100 MG TABLET   5 Specialty Tier 33%N/AP Q:180
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VENCLEXTA 50 MG TABLET   4 Non-Preferred Drug 50%44%P Q:14
/28Days
VENCLEXTA STARTING PACK   5 Specialty Tier 33%N/AP Q:42
/28Days
VENLAFAXINE HCL 100 MG TABLET [Effexor]   2 Generic $10.00$0.00None
VENLAFAXINE HCL 25 MG TABLET [Effexor]   2 Generic $10.00$0.00None
VENLAFAXINE HCL 37.5 MG TABLET [Effexor]   2 Generic $10.00$0.00None
VENLAFAXINE HCL 50 MG TABLET [Effexor]   2 Generic $10.00$0.00None
VENLAFAXINE HCL 75 MG TABLET [Effexor]   2 Generic $10.00$0.00None
VENLAFAXINE HCL ER 150 MG CAPSULE 24H [Effexor XR]   2 Generic $10.00$0.00Q:60
/30Days
VENLAFAXINE HCL ER 37.5 MG CAPSULE 24H [Effexor XR]   2 Generic $10.00$0.00Q:30
/30Days
VENLAFAXINE HCL ER 75 MG CAPSULE 24H [Effexor XR]   2 Generic $10.00$0.00Q:90
/30Days
Ventavis 0.01mg/mL   5 Specialty Tier 33%N/AP
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
Ventavis 0.02mg/mL   5 Specialty Tier 33%N/AP
VENTOLIN HFA 90MCG INHALER   3 Preferred Brand $47.00$116.00Q:36
/30Days
VERAPAMIL 120 MG TABLET   1 Preferred Generic $5.00$0.00None
VERAPAMIL 120MG CAP PELLET   3 Preferred Brand $47.00$116.00Q:60
/30Days
VERAPAMIL 180MG CAP PELLET   3 Preferred Brand $47.00$116.00Q:60
/30Days
VERAPAMIL 240MG CAP PELLET   3 Preferred Brand $47.00$116.00Q:60
/30Days
VERAPAMIL 40MG TABLET   1 Preferred Generic $5.00$0.00None
VERAPAMIL 80 MG TABLET   1 Preferred Generic $5.00$0.00None
VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS   2 Generic $10.00$0.00Q:30
/30Days
VERAPAMIL ER 120 MG TABLET   2 Generic $10.00$0.00None
VERAPAMIL ER 180 MG TABLET   2 Generic $10.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT)   2 Generic $10.00$0.00Q:60
/30Days
VERAPAMIL ER 240 MG TABLET   2 Generic $10.00$0.00None
VERAPAMIL ER PM 300 MG CAPSULE 24H PCT [Verelan PM]   2 Generic $10.00$0.00Q:30
/30Days
VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE   3 Preferred Brand $47.00$116.00Q:60
/30Days
VERIPRED 20 20 MG/5 ML SOLN   4 Non-Preferred Drug 50%44%None
VERSACLOZ 50 MG/ML ORAL SUSPENSION   5 Specialty Tier 33%N/AP Q:540
/30Days
VERZENIO 100 MG TABLET   5 Specialty Tier 33%N/AP Q:60
/30Days
VERZENIO 150 MG TABLET   5 Specialty Tier 33%N/AP Q:60
/30Days
VERZENIO 200 MG TABLET   5 Specialty Tier 33%N/AP Q:60
/30Days
VERZENIO 50 MG TABLET   5 Specialty Tier 33%N/AP Q:60
/30Days
VICTOZA 3-PAK 18 MG/3 ML PEN   3 Preferred Brand $47.00$116.00Q:9
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VIDEX 4 GM PEDIATRIC SOLN   4 Non-Preferred Drug 50%44%Q:1200
/30Days
VIDEX EC 125MG CAPSULE SA   4 Non-Preferred Drug 50%44%Q:90
/30Days
VIENVA-28 TABLET   4 Non-Preferred Drug 50%44%None
VIGABATRIN 500 MG ORAL TABLET [SABRIL]   5 Specialty Tier 33%N/AP Q:180
/30Days
VIGABATRIN 500 MG POWDER PACKET [SABRIL]   5 Specialty Tier 33%N/AP Q:180
/30Days
VIGABATRIN 500 MG TABLET [Sabril]   5 Specialty Tier 33%N/AP Q:180
/30Days
VIGADRONE 500 MG POWDER PACKET   5 Specialty Tier 33%N/AP Q:180
/30Days
VIIBRYD 10-20 MG STARTER PACK   4 Non-Preferred Drug 50%44%P Q:30
/30Days
VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE   4 Non-Preferred Drug 50%44%P Q:30
/30Days
VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE   4 Non-Preferred Drug 50%44%P Q:30
/30Days
VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE   4 Non-Preferred Drug 50%44%P Q:30
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VIMPAT 10 MG/ML SOLUTION   4 Non-Preferred Drug 50%44%Q:1395
/30Days
Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC   4 Non-Preferred Drug 50%44%None
Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC   4 Non-Preferred Drug 50%44%None
Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC   4 Non-Preferred Drug 50%44%None
Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC   4 Non-Preferred Drug 50%44%None
VIRACEPT 250MG TABLET   5 Specialty Tier 33%N/AQ:300
/30Days
VIRACEPT 625MG TABLET   5 Specialty Tier 33%N/AQ:120
/30Days
VIRAMUNE 50MG/5ML SUSP   5 Specialty Tier 33%N/AQ:1200
/30Days
VIREAD 150 MG TABLET   5 Specialty Tier 33%N/AQ:30
/30Days
VIREAD 200 MG TABLET   5 Specialty Tier 33%N/AQ:30
/30Days
VIREAD 250 MG TABLET   5 Specialty Tier 33%N/AQ:30
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VIREAD POWDER   5 Specialty Tier 33%N/AQ:240
/30Days
VITRAKVI 100 MG CAPSULE   5 Specialty Tier 33%N/AP Q:60
/30Days
VITRAKVI 20 MG/ML SOLUTION   5 Specialty Tier 33%N/AP Q:300
/30Days
VITRAKVI 25 MG CAPSULE   5 Specialty Tier 33%N/AP Q:180
/30Days
VIVITROL INJECTABLE SUSPENSION 380MG/VIAL   5 Specialty Tier 33%N/AQ:1
/28Days
VIZIMPRO 15 MG TABLET   5 Specialty Tier 33%N/AP Q:30
/30Days
VIZIMPRO 30 MG TABLET   5 Specialty Tier 33%N/AP Q:30
/30Days
VIZIMPRO 45 MG TABLET   5 Specialty Tier 33%N/AP Q:30
/30Days
VORICONAZOLE 200 MG TABLET [VFEND]   5 Specialty Tier 33%N/AP Q:120
/30Days
VORICONAZOLE 200 MG VIAL   5 Specialty Tier 33%N/AP
Voriconazole 40 MG/ML Oral Suspension   5 Specialty Tier 33%N/AP Q:400
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
VORICONAZOLE 50 MG TABLET [VFEND]   5 Specialty Tier 33%N/AP Q:120
/30Days
VOTRIENT 200 MG TABLET   5 Specialty Tier 33%N/AP Q:120
/30Days
VRAYLAR 1.5 MG CAP   5 Specialty Tier 33%N/AP Q:30
/30Days
VRAYLAR 1.5 MG-3 MG PACK   4 Non-Preferred Drug 50%44%P
VRAYLAR 3 MG CAP   5 Specialty Tier 33%N/AP Q:30
/30Days
VRAYLAR 4.5 MG CAP   5 Specialty Tier 33%N/AP Q:30
/30Days
VRAYLAR 6 MG CAP   5 Specialty Tier 33%N/AP Q:30
/30Days
Vyfemla 28 tablet   4 Non-Preferred Drug 50%44%None
VYLIBRA 28 TABLET   4 Non-Preferred Drug 50%44%None

Chart Legend:

Below are a few notes to help you understand the above 2019 Medicare Part D Humana Enhanced (PDP) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region). The plan name is followed by the plan type (PDP, HMO, HMO-POS, PPO, PFFS, etc.)

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $415 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have five (5) tiers 1=Preferred Generics, 2=Generics, 3=Preferred Brands, 4=Non-preferred Brands, 5=Specialty Drugs. *Some Part D plans exclude one or more drug tiers from the deductible. If the drug tier field above is followed by * (example: 2*), then this drug tier is excluded from the plan’s deductible.
    • Tier Description - This is the Medicare Part D plan’s description of this particular drug tier.
  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $3820) at a "Preferred" network pharmacy. In most cases, the "Preferred" network pharmacy cost-sharing is lower than the standard (non-preferred) network pharmacy cost-sharing.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).
  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2019 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.








Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.