Benefits
H5619-083 HMO
What is the Deductible for the member's drug coverage? and what tiers are excluded?
$245
Tiers 1 & 2 excluded
Using Pharmacy Calculator search drug:
Menest 1.25mg tab
2xday
90 day refill
What is the Tier level for plan Gold Plus HMO H5619-110 zip code 29483
Tier 4
Name a Preferred retailer in zip code 29483 Knightsville for the Humana Walmart Value Plan from page 1
Walmart
Im looking within 15 miles of zip code 29401
for an Edge by Humana plan for an address for John MacIlwaine (Orthopaedic Surgery)
125 Doughty St, Ste 280Charleston, South Carolina, 29403Charleston
Using the EOC- what is the definition of Coinsurance?
"Coinsurance"is the percentage you pay of the total cost of certain medical services. You pay a coinsurance at the time you get the medical service. (The Medical Benefits Chart in Section 2 tells you more about your coinsurance.)
H5619-132-002 HMO
Is there a max benefit in 2021 for Humana Pharmacy OTC drug & supplies?
No; there was a max benefit of $100 per every 3 mos.
Using Pharmacy Calculator search drug:
Nuvessa 1.3% vaginal gel
1x month
30 day refill
HumanaChoice PPO H5216-154 zip code 29483
Is this drug covered? Are there any alternatives?
Not covered; Alternatives-metronidazole
Walmart or Sams pharmacy,
I am looking within 15 miles of 29402
For a Humana Edge HMO plan
Sleep Apnea doctor Affiliated with Coastal Inpatient Physicians
Jeffrey Cluver or Bryan Tolliver
Using the EOC- what is Qualified Medicare Beneficiary (QMB)?
Helps pay Medicare Part A and Part B premiums, and other cost-sharing (like deductibles, coinsurance, and copayments). (Some people with QMB are also eligible for full Medicaid benefits (QMB+).)
H5216-238-002 PPO
How many meals per day does Mom's meal offer?
Receive 2 meals per day for 7 days, up to 14 meals delivered to member's home after an inpatient stay in a hospital or nursing facility.•Limited to 4 times per year.
Using Pharmacy Calculator search drug: zip code 29483
Rapamune 0.5 mg tablet
2x day
30 day refill
Humana Gold Plus HMO H5619-084 (zip-29483)
What is the Generic Equivalent and Estimated annual total?
Sirolimus; Estimated annual total$1,663.04
29403- Charleston, Humana Basic RX Plan find a pharmacy in the Veterans Admin network within 2 miles
Im looking within 15 miles of zip code 29401
for an Edge by Humana plan, Cardiologist
4 stars and up for clincial quality- Male
Wills, Geils OR Gregory, Miller
Using the EOC- what is the definition of Copay?
A "copayment"is the fixed amount you pay each time you receive certain medical services. You pay a copayment at the time you get the medical service. (The Medical Benefits Chart in Section 2 tells you more about your copayments.)
H5216-237 (PPO)
What is the Out of Network lifetime limit for a psychiatric facility for an Inpatient Mental Health Care service?
190 day lifetime limit in a psychiatric facility
(zip-29483 ) Using Pharmacy Calculator search drug:
Humana Gold Plus HMO H5619-083
Sirolimus 0.5 mg tablet
2xday
30 day refill
What refills will the member fall into the coverage gap?
Member in coverage gap: Fills 11 - 12
Zip 29403 Charleston
Humana Walmart Value plan- find a pharmacy in the standard cost share network within 1 mile
CVS or Community- A Walgreens Pharmacy
I am looking within 15 miles of 29403
for a Edge by Humana HMO
Is Michael Johnson accepting new patients?
Yes
Using the EOC- What is a (SPAP) ?
State Pharmaceutical Assistance Programs help some people pay for prescription drugs based on financial need, age, medical condition, or disabilities. Each state has different rules to provide drug coverage to its members
HumanaChoice H5216-075 (PPO)
A member has paid a total of $6700 True out of Pocket for the year within their pharmacy plan. What is the stage as well as the cost for a tier 3 drug?
Stage 4 Catastrophic Coverage (after TrOOP)
Member pays the greater of $3.70 for generic/preferred multi-source drugs/biosimilars and $9.20 for all other drugs; OR 5% coinsurance.
Using Pharmacy Calculator search drug:
zip code 29483
Name the one plan in this service area that does not have a pharmacy deductible
Humana Gold Plus HMO H5619-110
Zip code 29404- Charleston
Humana Premier Plan
How many pharmacies are out of network?
49
I am looking with 15 miles of 29404 for
Humana Edge HMO for a Diabetic supplier who has a focus in breast pumps
Mckesson Patient Care Solutions Inc
Using the EOC- what is the definition of
What is a "PCP" and what does the PCP do for you?
A "PCP"is your Primary Care Provider. When you become a member of the plan, you must choose a network doctor to be your PCP. Your PCP is a provider who meets state license requirements and is trained to give you basic medical care.