Humana is a private insurer that offers Part D prescription drug coverage with some of its Medicare Advantage plans. The company also offers three stand-alone Part D options.
Medicare Part D covers prescription drugs and is available to anyone with Original Medicare (parts A and B). Alternatively, people may have a Medicare Advantage plan (Part C) from a private insurer that includes the same coverage as Original Medicare and often includes prescription drug coverage (Part D).
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Humana is a for-profit insurance provider with headquarters in Louisville, KY. It operates in all 50 states, plus Washington, D.C., and Puerto Rico.
Humana offers Medicare Advantage plans that provide at least the same coverage as Original Medicare (parts A and B). However, unlike Original Medicare, many Humana Medicare Advantage plans offer dental, vision, hearing, and prescription drug coverage.
Humana offers Medicare Advantage prescription drug plans (MAPDs) and stand-alone prescription drug plans.
Medicare Advantage prescription drug plans
An MAPD may be a good choice for people who prefer the simplicity of one plan that covers parts A, B, and D. It may also cover routine dental, hearing, and vision benefits and offer lower out-of-pocket costs for premiums, copays, and deductibles.
However, most Medicare Advantage plans require people to only use doctors in the plan’s network and service area, which can be problematic for people who may need medical services away from home.
Humana offers several Medicare Advantage plan types, including:
All Humana SNPs and most of their HMO plans include drug coverage. Some PPO and PFFS plans also include this benefit.
Stand-alone prescription drug plans
A stand-alone Part D plan may be a good choice for people who need coverage wherever they travel in the United States. Original Medicare allows a person to receive medical services from any provider that accepts Medicare anywhere in the country.
Humana offers several stand-alone prescription drug plans:
- Humana Value Rx Plan: With this plan, members can save on generic medications and use over 9,000 cost-sharing pharmacies nationwide.
- Humana Basic Rx Plan: This plan offers basic coverage, and people can access the preferred cost-sharing network.
- Humana Premier Rx Plan: This is Humana’s most comprehensive Part D plan. It has an extensive formulary.
People taking several medications with various prescriptions might benefit from the Humana Medication Therapy Management program. People can meet with a doctor or pharmacist to learn about their prescription medications, ask questions, and explore opportunities to lower their costs.
This online tool can help people search Medicare Advantage plans and PDPs.
Like other Part D plans, Humana Medicare Part D plans use a formulary. This is a list of covered medications divided into tiers.
Typically, lower-tier drugs include generics that cost less than brand-name and specialty medications, which are typically in the upper tiers.
Insurance providers can decide which drugs to include, but Medicare rules state that each Part D plan covers at least two medications from the most commonly prescribed categories and classes.
All Part D plans are required to include most drugs from certain protected classes:
- anticancer drugs (unless they’re under Medicare Part B coverage)
- anticonvulsants
- antidepressants
- antipsychotic medications
- HIV medications
- immunosuppressant medications for organ transplants
Part D plans must also cover all commercially available vaccines, except those that Medicare Part B covers, such as the annual flu shot.
Costs for Humana MAPD and PDP plans vary according to several factors. These include the following:
Premium
Both MAPDs and PDPs have monthly premiums, though in some cases, this could be $0. A person who is enrolled in a Medicare Advantage plan will continue to pay the Medicare Part B premium of $185 in 2025, and Part A, if applicable, in addition to Humana’s monthly premium.
Some Humana Medicare Advantage plans may contribute toward the Medicare Part B premium.
Copay
When someone gets a prescription, they must pay either a fixed copay amount or coinsurance, which is a percentage of the cost.
Plans have a yearly cap on what someone needs to pay for their medication.
Deductible
People with a Medicare Advantage plan must pay a deductible, which is the amount that is due before Humana contributes toward the costs.
Some plans have a $0 deductible.
An example of 2025 costs for someone living in New York and opting for the Humana Choice PPO plan, which includes drug coverage, is:
- $0 monthly premium plus the $185 Part B premium
- $270 annual health deductible
- $425 drug deductible
- $0 primary doctor visit (in network) or $30 (out of network)
- $40 specialist visit copay (in network) or $75 (out of network)
- $2 preferred generic drug copay
The table below compares costs for Humana stand-alone drug plans for someone in New York.
| Humana Value Rx Plan (PDP) | Humana Basic Rx Plan (PDP) | Humana Premier Rx Plan (PDP) | |
|---|---|---|---|
| Monthly premium | $108.90 | $120.60 | $170.40 |
| Annual prescription deductible | $0 for tiers 1 and 2 $573 for tiers 3, 4, and 5 | $590 on all tiers | $0 |
Plans may stipulate that a person uses specific pharmacies or pharmacy networks. People may also have options for mail-order pharmacies.
People must meet specific criteria to enroll in a Humana MAPD or PDP.
In general, a person must be 65 years of age or older, though younger people can enroll if they:
- have had Social Security Disability Insurance for at least 24 months (2 years)
- have a specific health condition, such as end stage renal disease or amyotrophic lateral sclerosis
- become eligible through family relationships
People 65 years and over must be enrolled in Original Medicare to be eligible for Part D. People with a Medicare Advantage plan cannot enroll in Part D, as most Advantage plans include prescription drug coverage.
People can check their eligibility to join a Part D plan by using the Medicare Eligibility & Premium Calculator.
In 2024, the Centers for Medicare & Medicaid services (CMS) released details of changes to Part D plans for 2025.
The most significant change is an annual cap of $2,000 on prescription drug out-of-pocket costs. This eliminates the coverage gap or “donut hole” that meant people with drug costs over a certain threshold were responsible for paying a large portion of the costs out of pocket.
Also effective in 2025 is the introduction of a Medicare prescription payment plan. This allows people to spread the costs of their prescription drugs by paying in monthly installments rather than in one lump sum.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Humana offers three stand-alone Part D plans for prescription drug coverage. They also offer Medicare Advantage plans that include drug coverage.
A person enrolled in Original Medicare can extend their health coverage with a stand-alone Part D drug plan. This gives greater flexibility over where people receive medical services.
A Medicare Advantage plan that includes prescription drug coverage may carry lower out-of-pocket costs but limit the choice of healthcare professionals.
Changes to Medicare Part D in 2025 may make prescription drugs more affordable and easier to budget for.