Humana is the fourth-largest company offering Medicare Part D plans. About 3.5 million Medicare beneficiaries have Humana Part D plans as of April 2022.
Humana’s overall star rating from the Centers for Medicare & Medicaid Services is close to average, but its plans fall short on eight out of 12 Medicare Part D quality measures.
While Humana Medicare Part D plans generally make generic drugs affordable with low copay and deductible requirements, coinsurance for brand-name drugs could lead to higher out-of-pocket costs.
Here’s what you should know about Humana Medicare Part D prescription drug plans.
Humana Medicare Part D pros and cons
Medicare prescription drug plans from Humana have advantages and disadvantages.
Available Medicare Part D prescription drug plans
Medicare beneficiaries with Original Medicare (Part A and/or Part B) can purchase a Medicare Part D plan for prescription drug coverage. Part D plans are sold by private insurance companies. The costs and coverage can vary significantly, so it’s important to compare options.
Humana offers three stand-alone Medicare prescription drug plans for 2022:
Humana Walmart Value Rx: According to Humana, this plan is best for “members looking for a plan with an affordable premium that also provides valuable benefits such as copays as low as $0 (depending on region) and a $0 deductible on Tier 1 and Tier 2 drugs.”
Humana Basic Rx: According to Humana, this plan is best for “members who qualify for Extra Help, which may cover the entire cost of the premium on this plan, and for people who want affordable basic coverage with access to a preferred cost-sharing network.”
Humana Premier Rx: According to Humana, this plan is best for “members who want the security of our most comprehensive prescription drug plan, with copays as low as $0 and $0 deductibles on over 900 Tier 1 and Tier 2 drugs.”
Humana Medicare Part D service area
Stand-alone Medicare prescription drug plans from Humana are available in all 50 states, Washington, D.C., and Puerto Rico.
Humana offers all three of its Medicare Part D plan options in all U.S. states and Washington, D.C. Puerto Rico has two options: Humana Basic Rx and Humana Premier Rx (Humana Walmart Value Rx is unavailable).
Humana Medicare Part D premiums and deductibles
Here are the 2022 premiums and deductibles for Humana’s stand-alone Medicare prescription drug plans:
Humana Medicare Part D drug formulary tiers
A formulary is a list of the prescription drugs covered by an insurance plan. The plans often organize different kinds of drugs into tiers according to the cost of the drugs.
Humana’s prescription drug plans use a five-tier formulary:
Tier 1: Preferred generics
More common, lower-cost generic prescription drugs.
Higher-cost generic prescription drugs and some lower-cost brand-name drugs.
Brand-name drugs with no generic drug equivalent.
Tier 4: Non-preferred drug
Higher-priced brand-name and generic drugs with no preferred cost sharing.
The most expensive drugs that are used to treat complex medical conditions such as cancer, multiple sclerosis or rheumatoid arthritis.
Each tier has copay or coinsurance requirements. You’ll generally pay more for drugs listed in higher tiers up to Tier 4, but Tier 5 specialty drugs have a lower coinsurance requirement than Tier 4 drugs.
The drugs included in tiers and what you’ll pay for each tier depends on your choice of prescription drug plan and what kind of pharmacy you use. For example, Humana plans have the lowest copays for prescriptions you fill through Humana-preferred mail-order pharmacies. For retail pharmacies, preferred (in-network) pharmacies can have significantly lower cost-sharing requirements than non-preferred pharmacies.
Deductibles can also apply differently depending on the formulary tier. For example, the Humana Walmart Value Rx and Humana Premier Rx plans have no deductible for Tier 1 and Tier 2 drugs. The Humana Basic Rx plan has a deductible for all tiers.
The Humana Basic Rx and Humana Premier Rx plans have $0 copays for Tier 1 drugs from preferred mail-order pharmacies, while the Walmart Value Rx plan can have copays of up to $3 from preferred mail-order pharmacies. After Tier 1, cost-sharing requirements can quickly get more expensive. As a result, it’s important to check where your medications and pharmacies fall on each plan’s formulary.
Coinsurance vs. copay requirements
You’ll also want to check whether you’ll pay a copay or coinsurance for your medications. Copays are set dollar amounts, so it’s easy to see what you’ll pay. Coinsurance is a percentage of the price for your medications, so coinsurance requirements can be more unpredictable and more expensive.
Humana starts charging coinsurance rather than copays at different formulary tiers for each of its plans:
Humana Walmart Value Rx: Copays for Tiers 1-2; coinsurance at Tier 3 and above.
Humana Basic Rx: Copays for Tiers 1-2 from preferred mail-order pharmacies; coinsurance at Tier 3 and above. Tier 1-2 drugs from retail pharmacies might have either copays or coinsurance depending on your region.
Humana Premier Rx: Copays for Tiers 1-3; coinsurance for Tiers 4-5.
You can enter your medications and pharmacy information on Humana’s website to see which drugs are covered and review your estimated costs with different plan options.
Humana Medicare Part D star ratings
Average Part D star rating: 3.67
The Centers for Medicare & Medicaid Services rates Medicare Part D plans on 12 quality measures. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)
These ratings use a 5-point scale where 5 is the best and 1 is the worst. The agency bases its ratings on drug plans’ quality of service and customer experiences, and ratings are updated annually.
Based on the most recent year of data, stand-alone Humana prescription drug plans get an overall rating of 3.67 stars. The 2022 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.7 stars.
Compare Humana Part D star ratings
Stand-alone Medicare Part D plans from Humana outperformed the national average on four Part D measures, but fell behind the national average on eight measures.
Here’s how stand-alone Humana prescription drug plans compared with national averages for each of the 12 Part D measures:
Measures on which Humana plans outperformed
Measures on which Humana fell behind
American Customer Satisfaction Index: 74 out of 100
The American Customer Satisfaction Index, or ACSI, rates consumer satisfaction with products and services based on a scientific model developed at the University of Michigan. Ratings are derived from surveys that measure consumers’ expectations and perceived quality and value of products and services.
In 2021, Humana scored 74 out of 100 on the ACSI health insurance satisfaction benchmark. ACSI measures satisfaction with the health insurance industry as a whole — Humana’s score represents all of its health insurance products, not just Medicare Part D insurance. For comparison, the highest score was 75 and the health insurance industry average was 73.
AM Best Financial Strength Rating: A-
AM Best is a credit rating agency that specializes in the insurance industry. In October 2021, AM Best affirmed its Financial Strength Rating of A- (Excellent) for the majority of health and dental subsidiaries of Humana Inc. AM Best also affirmed an FSR of B++ (Good) for Humana’s Puerto Rico subsidiaries, collectively referred to as Humana Health of Puerto Rico Group.
An A- rating in this category indicates that AM Best believes Humana has an excellent ability to meet its ongoing insurance obligations. A B++ rating indicates that AM Best believes Humana Health of Puerto Rico Group has a good ability to meet ongoing insurance obligations.
Humana is a health insurance company headquartered in Louisville, Kentucky. Its insurance offerings include Medicare Advantage plans, Medicare prescription drug plans, Medicare Supplement Insurance, employer-sponsored policies, Medicaid coverage and dental and vision plans. As of June 2021, Humana had about 8.6 million members across all of its Medicare products. Humana posted annual revenue of $83.1 billion in 2021.
Find the right Medicare Part D prescription drug plan
The interactive tool on Medicare.gov can help find a Medicare Part D plan that covers your prescriptions. It also helps you compare costs among Medicare Part D and Medicare Advantage plans available to you.
Here are some things to keep in mind when comparing plans:
Check the formulary: You’ll want to make sure the medicines you currently take and, importantly, any you think you might need in the future, are covered under each of the plans you’re considering. Talk to your health care providers about what brand-name and generic medicines to look for and any alternatives that may also work in case you can’t find your current medicines on the plans available in your area.
Look for plan changes: Formularies change frequently. Your insurer should send you a Notice of Plan Change when the formulary changes. Read this document carefully.
Check the pharmacy network: Most Medicare Part D plans negotiate with a network of pharmacies for the lowest cost. Check to see if your pharmacy or an equally convenient one is in the plan’s network. Also, compare prices for using mail order.
If your plan does change, and the change affects the prescription drugs you need, you can switch plans during Medicare’s open enrollment period, Oct. 15 to Dec. 7. Changes go into effect on the following Jan. 1.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).