Transcription
Alaska AlaskaMarket Service AreaAleutians East, Aleutians West, Anchorage, Bethel, Bristol Bay,Denali, Dillingham, Fairbanks North Star, Haines, Juneau, KenaiPeninsula, Ketchikan Gateway, Kodiak Island, Lake AndPeninsula, Matanuska Susitna, Nome, North Slope, NorthwestArctic, Prince of Wales-Outer Ketchikan, Prince WalesKetchikan, Sitka, Skagway Hoonah Angoon, Skagway-HoonahAngoon, Southeast Fairbanks, Valdez Cordova, Wade Hampton,Wrangell Petersburg, Wrangell-Petersburg, Yakutat, YukonKoyukukFOR AGENT USE ONLY
Alaska AlaskaPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaAleutians East, Aleutians West, Anchorage,Bethel, Bristol Bay, Denali, Dillingham,Fairbanks North Star, Haines, Juneau, KenaiPeninsula, Ketchikan Gateway, Kodiak Island,Lake And Peninsula, Matanuska Susitna,Nome, North Slope, Northwest Arctic, Princeof Wales-Outer Ketchikan, Sitka, SkagwayHoonah-Angoon, Southeast Fairbanks, ValdezCordova, Wade Hampton, WrangellPetersburg, Yakutat, Yukon KoyukukAleutians East, Aleutians West, Anchorage,Bethel, Bristol Bay, Denali, Dillingham,Fairbanks North Star, Haines, Juneau, KenaiPeninsula, Ketchikan Gateway, Kodiak Island,Lake And Peninsula, Matanuska Susitna,Nome, North Slope, Northwest Arctic, Princeof Wales-Outer Ketchikan, Sitka, SkagwayHoonah-Angoon, Southeast Fairbanks, ValdezCordova, Wade Hampton, WrangellPetersburg, Yakutat, Yukon KoyukukAleutians East, Aleutians West, Anchorage,Bethel, Bristol Bay, Denali, Dillingham,Fairbanks North Star, Haines, Juneau, KenaiPeninsula, Ketchikan Gateway, Kodiak Island,Lake And Peninsula, Matanuska Susitna,Nome, North Slope, Northwest Arctic, Princeof Wales-Outer Ketchikan, Sitka, SkagwayHoonah-Angoon, Southeast Fairbanks, ValdezCordova, Wade Hampton, WrangellPetersburg, Yakutat, Yukon KoyukukPlan NamePlan NumberFOR AGENT USE ONLY
Alaska AlaskaOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppFOR AGENT USE ONLY
Alaska AlaskaLocal SupportLocal Support - AlaskaLon GirardBroker Relationship Manager360-852-1831lgirard@humana.comOR, WA, AKMonica FlorenzanBroker Relationship Executive855-216-7109mflorenzan@humana.comOR, WA, AKLocal Market Office1-800-781-4203FOR AGENT USE ONLY
California California OutstateMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following:Market Service AreaAlameda, Alpine, Amador, Butte, Calaveras, Colusa, Del Norte,El Dorado, Glenn, Humboldt, Inyo, Lake, Lassen, Marin,Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa,Nevada, Placer, Plumas, Sacramento, San Benito, SanFrancisco, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra,Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Tuolumne,Yolo, YubaFOR AGENT USE ONLY
California California OutstatePrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaCalifornia Outstate Market-wideCalifornia Outstate Market-wideCalifornia Outstate Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California California OutstateOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California California OutstateLocal SupportLocal Support - CaliforniaShirley ToddBroker Relationship Manager805-952-3823stodd3@humana.comCA - NorthernJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office925-255-0910FOR AGENT USE ONLY
California Contra CostaMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.Good hearing is important to your health. That’s whysome Humana Medicare Advantage plans include ahearing aid benefit through TruHearing .Many Humana plans include a Well Dine benefit, whichcan provide packaged, precooked meals right tomember's doors during recovery.Optional Supplemental Benefits that include Dental &VisionFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Hill PhysiciansMedical Group, John Muir Physician Network and SutterEast Bay Medical FoundationMarket Service AreaContra Costa
California Contra CostaMAPDPlan NameHumana Gold Plus (HMO)Plan NumberH5619-029-000Plan HighlightsHigh Plan Premium HMO MAPD Plan withthe option to purchase supplementalbenefitsPremium 91PCP 0Specialist 12Referrals RequiredYesInpatient Hospital 370 per day Days 1-4Max Out-of-Pocket 5900 In-NetworkRx Deductible 400 tiers 3-5Rx Preferred 5/ 12/ 47/ 100/25%Key Extra BenefitsHearingMarket Service AreaContra Costa Market-wideFOR AGENT USE ONLY
California Contra CostaPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaContra Costa Market-wideContra Costa Market-wideContra Costa Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California Contra CostaOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California Contra CostaLocal SupportLocal Support - CaliforniaShirley ToddBroker Relationship Manager805-952-3823stodd3@humana.comLocal Sales ManagerCharlene MiskimenLocal Sales Manager415-590-9087cmiskimen@humana.comContra CostaCA - NorthernJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office925-255-0910FOR AGENT USE ONLY
California Fresno - MaderaMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.Multiple selling opportunities with Dual Special NeedsPlansOptional Supplemental Benefits that include Dental &VisionYour plan may include a monthly or quarterly allowancefor over-the-counter(OTC) items such as: Vitamins, PainRelievers, and Cough and cold medicinesFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Central ValleyMedical Providers, Choice Physicians NetworkMarket Service AreaFresno, Madera
California Fresno - MaderaMAPDPlan NameHumana Gold Plus (HMO)Humana Gold Plus (HMO)Plan NumberH5619-012-000H5619-013-000Plan Highlights 0 Plan Premium HMO MAPD Plan withthe option to purchase supplementalbenefits 0 Plan Premium HMO MAPD Plan withthe option to purchase supplementalbenefitsPremium 0 0PCP 0 0Specialist 10 10Referrals RequiredYesYesInpatient Hospital 250 per day Days 1-5 295 per day Days 1-6Max Out-of-Pocket 3100 In-Network 5900 In-NetworkRx DeductibleNo DeductibleNo DeductibleRx Preferred 5/ 15/ 47/ 100/33% 5/ 15/ 47/ 100/33%Key Extra BenefitsHearing, OTC 25/Quarter for selecthealth and wellness productsHearing, OTC 25/Quarter for selecthealth and wellness productsMarket Service AreaFresnoMaderaFOR AGENT USE ONLY
California Fresno - MaderaDSNPPlan NameHumana Gold Plus SNP-DE (HMO D-SNP)Plan NumberH5619-038-000Plan HighlightsDual Eligible Special Needs plan forFBDE,QMB ,SLMB . Includes suite of richsupplemental benefits designed for dualmember needs.Dental 1000 annually; 0 copayments covers:exams, x-rays, cleanings, fillings, crowns,extractions, denturesHealthy Foods Card 25 maximum monthly allowance on aHealthy Foods Card for a member to spendtowards the purchase of approved food andbeverage items at participating retailersVisionAnnual exam and 300 credit every year foreyeglasses or contact lenses.HearingAnnual exam, fitting and 2000 credit forhearing aids.OTC Allowance 150 maximum benefit coverage amount perquarter (3 months) for select over-the-counterhealth and wellness products.Transportation 0 copayment for plan approved location upto 36 one-way trip(s) per year by car, van,wheelchair access vehicle.This benefit is not to exceed 50 miles per trip.Current Service AreaFresno - Madera Market-wideFOR AGENT USE ONLY
California Fresno - MaderaPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaFresno - Madera Market-wideFresno - Madera Market-wideFresno - Madera Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California Fresno - MaderaOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California Fresno - MaderaLocal SupportLocal Support - CaliforniaShirley ToddBroker Relationship Manager805-952-3823stodd3@humana.comLocal Sales ManagerRichard DuranLocal Sales Manager559-696-7676rduran1@humana.comFresno, Madera CountyCA - NorthernJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office559-221-2522FOR AGENT USE ONLY
California Kern CountyMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.Multiple selling opportunities with Dual Special NeedsPlansNew MA-Only plan available with Comprehensive Dentaland a 75 Part B Giveback for customers that get theirdrug coverage elsewhere, such as Veterans.Your plan may include a monthly or quarterly allowancefor over-the-counter(OTC) items such as: Vitamins, PainRelievers, and Cough and cold medicinesFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Bakersfield FamilyMedical Center, QualCare and Hispanic Physicians IPA.Most major hospital facilities within the market are innetworkMarket Service AreaKern
California Kern CountyMA / MAPDNEWPlan NameHumana Gold Plus (HMO)Humana Gold Plus (HMO)Plan NumberH5619-116-000H5619-121-000Plan Highlights 0 Plan Premium HMO MAPD Plan withrich benefits and additional ancillariesMA Only plan with a 75 Part B PremiumGiveback, designed for individuals that donot need additional drug coverage. Greatfit for Veterans using the VA for drugcoverage.Premium 0 0PCP 0 20Specialist 0 50Referrals RequiredYesYesInpatient Hospital 0 per admission 1860 per admissionMax Out-of-Pocket 2500 In-Network 6700 In-NetworkRx DeductibleNo DeductibleNo CoverageRx Preferred 0/ 9/ 47/ 100/33%No CoverageKey Extra BenefitsDental, Vision, Hearing, Fitness, OTC 25/Quarter for select health andwellness productsDentalMarket Service AreaKern County Market-wideKern County Market-wideFOR AGENT USE ONLY
California Kern CountyDSNPPlan NameHumana Gold Plus SNP-DE (HMO D-SNP)Plan NumberH5619-038-000Plan HighlightsDual Eligible Special Needs plan forFBDE,QMB ,SLMB . Includes suite of richsupplemental benefits designed for dualmember needs.Dental 1000 annually; 0 copayments covers:exams, x-rays, cleanings, fillings, crowns,extractions, denturesHealthy Foods Card 25 maximum monthly allowance on aHealthy Foods Card for a member to spendtowards the purchase of approved food andbeverage items at participating retailersVisionAnnual exam and 300 credit every year foreyeglasses or contact lenses.HearingAnnual exam, fitting and 2000 credit forhearing aids.OTC Allowance 150 maximum benefit coverage amount perquarter (3 months) for select over-the-counterhealth and wellness products.Transportation 0 copayment for plan approved location upto 36 one-way trip(s) per year by car, van,wheelchair access vehicle.This benefit is not to exceed 50 miles per trip.Current Service AreaKern County Market-wideFOR AGENT USE ONLY
California Kern CountyPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaKern County Market-wideKern County Market-wideKern County Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California Kern CountyOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California Kern CountyLocal SupportLocal Support - CaliforniaEdward MartinBroker Relationship Manager661-481-8189emartin5@humana.comLocal Sales ManagerDaralynn KingLocal Sales Manager818-257-0559dking36@humana.comKern CountyCA - Los AngelesJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office424-246-4834FOR AGENT USE ONLY
California Los AngelesMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.New MA-Only plan with Comprehensive Dental and a 90 Part B giveback available for customers that gettheir drug coverage elsewhere, such as Veterans.Plan available with Transportation BenefitPlans may include Comprehensive Dental coverageYour plan may include a monthly or quarterly allowancefor over-the-counter(OTC) items such as: Vitamins, PainRelievers, and Cough and cold medicinesFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Regal-Lakesive MG,HealthCare Partners, Facey MG, THIPA, Prospect MG,High Desert MG and Heritage-Sierra MGMost major hospital facilities within the market are innetworkMarket Service AreaLos Angeles
California Los AngelesMA / MAPDNEWPlan NameHumana Gold Plus (HMO)Humana Gold Plus (HMO)Plan NumberH5619-021-000H5619-120-000Plan Highlights 0 Plan Premium HMO MAPD Plan withrich benefits and additional ancillariesincluding Comprehensive DentalMA Only plan with a 90 Part B PremiumGiveback, designed for individuals that donot need additional drug coverage. Greatfit for Veterans using the VA for drugcoverage.Premium 0 0PCP 0 20Specialist 0 50Referrals RequiredYesYesInpatient Hospital 0 per admission 1860 per admissionMax Out-of-Pocket 990 In-Network 6700 In-NetworkRx DeductibleNo DeductibleNo CoverageRx Preferred 0/ 0/ 35/ 100/33%No CoverageKey Extra BenefitsDental, Vision, Hearing, Fitness, OTC 125/Quarter for select health andwellness productsDentalMarket Service AreaLos Angeles Market-wideLos Angeles Market-wideFOR AGENT USE ONLY
California Los AngelesPlan NameHumana Value Plus (HMO)Plan NumberH5619-037-000Plan HighlightsLean medical and pharmacy benefits, withrich supplemental benefitsDental 1000 annually; 0 copayments covers:exams, x-rays, cleanings, fillings, crowns,extractions, denturesVisionAnnual exam and 200 credit every year foreyewear or contact lenses including fittings.HearingAnnual exam and fitting. 1000 credit forhearing aids once every 3 years.OTC Allowance 100 maximum benefit coverage amount perquarter (3 months) for select over-the-counterhealth and wellness products.Transportation 0 copayment for plan approved location upto 36 one-way trip(s) per year by car, van,wheelchair access vehicle.This benefit is not to exceed 50 miles per trip.Current Service AreaLos Angeles Market-wideFOR AGENT USE ONLY
California Los AngelesPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaLos Angeles Market-wideLos Angeles Market-wideLos Angeles Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California Los AngelesOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California Los AngelesLocal SupportLocal Support - CaliforniaEdward MartinBroker Relationship Manager661-481-8189emartin5@humana.comLocal Sales ManagerDaralynn KingLocal Sales Manager818-257-0559dking36@humana.comSan Fernando ValleyCA - Los AngelesJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office424-246-4834Keisha SmithLocal Sales Manager951-348-0854ksmith46@humana.comSan Gabriel ValleyRonald MoralesLocal Sales Manager951-218-1321rmorales4@humana.comSouth Los Angeles, Los Angeles CountyFOR AGENT USE ONLY
California San BernardinoMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.Many Plans include Dental, Vision, Hearing, OTC andSilverSneakers Fitness BenefitsNew MA-Only plan with Comprehensive Dental and a 75 Part B giveback available for customers that gettheir drug coverage elsewhere, such as Veterans.Some Humana Plans include Routine non-emergentmedical transportation at no additional costFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Heritage VictorValley MG, Regal MG, PrimeCare MG, Upland MGMarket Service AreaSan Bernardino
California San BernardinoMA / MAPDNEWPlan NameHumana Gold Plus (HMO)Humana Gold Plus (HMO)Plan NumberH5619-039-002H5619-121-000Plan Highlights 0 Plan Premium HMO MAPD Plan withrich benefits and additional ancillariesMA Only plan with a 75 Part B PremiumGiveback, designed for individuals that donot need additional drug coverage. Greatfit for Veterans using the VA for drugcoverage.Premium 0 0PCP 0 20Specialist 0 50Referrals RequiredYesYesInpatient Hospital 0 per admission 1860 per admissionMax Out-of-Pocket 1499 In-Network 6700 In-NetworkRx DeductibleNo DeductibleNo CoverageRx Preferred 0/ 5/ 47/ 100/33%No CoverageKey Extra BenefitsDental, Vision, Hearing, Fitness, OTC 30/Quarter for select health andwellness productsDentalMarket Service AreaSan Bernardino Market-wideSan Bernardino Market-wideFOR AGENT USE ONLY
California San BernardinoPlan NameHumana Value Plus (HMO)Plan NumberH5619-037-000Plan HighlightsLean medical and pharmacy benefits, withrich supplemental benefitsDental 1000 annually; 0 copayments covers:exams, x-rays, cleanings, fillings, crowns,extractions, denturesVisionAnnual exam and 200 credit every year foreyewear or contact lenses including fittings.HearingAnnual exam and fitting. 1000 credit forhearing aids once every 3 years.OTC Allowance 100 maximum benefit coverage amount perquarter (3 months) for select over-the-counterhealth and wellness products.Transportation 0 copayment for plan approved location upto 36 one-way trip(s) per year by car, van,wheelchair access vehicle.This benefit is not to exceed 50 miles per trip.Current Service AreaSan Bernardino Market-wideFOR AGENT USE ONLY
California San BernardinoPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan HighlightsLowest premium and access to preferredbenefits at Walmart and Humana Pharmacy.Richest formulary and benefits. Preferredbenefits at Walmart and Humana Pharmacy.Primarily provides coverage for members withExtra Help (LIS). Tier 1 & Tier 2 mail-ordercopays are 0 at Humana Pharmacy for 90day supply.Pairs Well WithHumana Med Supp PlanHumana Med Supp PlanHumana Med Supp PlanPremiumComing SoonComing SoonComing SoonRx Deductible 435 tiers 3-5 435 tiers 3-5 435 all tiersPreferred Retail 30-day Supply 1/ 4/ 47/35%/25% 1/ 4/ 42/44%/25%No CoverageStandard Retail 30-day Supply 10/ 20/ 47/50%/25% 5/ 10/ 47/50%/25% 0/ 1/25%/35%/25%Preferred Mail 90-day Supply 3 copay for tier 1, 12 copayment for tier 2 0 copay for tiers 1 & 2 0 copay for tiers 1 & 2Market Service AreaSan Bernardino Market-wideSan Bernardino Market-wideSan Bernardino Market-widePlan NamePlan NumberFOR AGENT USE ONLY
California San BernardinoOther PlansPlan NamePlan NumberPlan CategoryHumana Med SuppPlan AMed SuppHumana Med SuppPlan BMed SuppHumana Med SuppPlan CMed SuppHumana Med SuppPlan FMed SuppHumana Med SuppPlan F(HD)Med SuppHumana Med SuppPlan KMed SuppHumana Med SuppPlan LMed SuppHumana Med SuppPlan NMed SuppFOR AGENT USE ONLY
California San BernardinoLocal SupportLocal Support - CaliforniaEdward MartinBroker Relationship Manager661-481-8189emartin5@humana.comLocal Sales ManagerKeisha SmithLocal Sales Manager951-348-0854ksmith46@humana.comSan Bernardino CountyCA - Los AngelesJared LarsonBroker Relationship Executive855-305-4952jlarson1@humana.comCA- Northern & Los AngelesLocal Market Office424-246-4834FOR AGENT USE ONLY
California San Joaquin - StanislausMARKET HIGHLIGHTS 0 copay for 90 day supply of tier 1 and 2 drugs whenusing mail order through Humana PharmacyGo365 by Humana is a wellness program that rewardsyour clients for doing healthy activities. Many HumanaMedicare Advantage plans include Go365.Multiple selling opportunities with Dual Special NeedsPlansPartnership with MedCore (Omni) to offer the HumanaCommunity Plan an MAPD HMOYour plan may include a monthly or quarterly allowancefor over-the-counter(OTC) items such as: Vitamins, PainRelievers, and Cough and cold medicinesFOR AGENT USE ONLYNetwork HighlightsFor a complete list of in-network providers, visitwww.Humana.com/PhysicianFinderIn-network HMO hospitals and provider systems include,but are not limited to, the following: Stanislaus County AllCare IPA, San Joaquin County - MedCore (Omni IPA),AllCare IPA, Hill Physicians Medical Group and SutterGould Medical FoundationMarket Service AreaSan Joaquin, Stanislaus
California San Joaquin - StanislausMAPDPlan NameHumana Community (HMO)Humana Gold Plus (HMO)Humana Gold Plus (HMO)Plan NumberH7621-003-000H5619-032-000H5619-026-000Plan HighlightsLow Plan Premium HMO MAPD Plan, inpartnership with MedCore (Omni) withrich benefits and additional ancillariesLow Plan Premium HMO MAPD Plan withrich benefits and additional ancillariesHigh Plan Premium HMO MAPD Plan withrich benefits and additional ancillariesPremium 19 19 57PCP 0 0 0Specialist 0 10 10Referrals RequiredYesYesYesInpatient Hospital 200 per day Days 1-5 200 per day Days 1-5 250 per day Days 1-6Max Out-of-Pocket 2900 In-Network 3400 In-Network 3400 In-NetworkRx DeductibleNo DeductibleNo DeductibleNo DeductibleRx Preferred 2/ 10/ 47/ 100/33% 0/ 10/ 47/ 100/33% 4/ 15/ 47/ 100/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC 45/Quarter for select health andwellness productsDental, Vision, Hearing, Fitness, OTC 30/Quarter for select health andwellness productsVision, Hearing, FitnessMarket Service AreaSan JoaquinStanislausSan JoaquinFOR AGENT USE ONLY
California San Joaquin - StanislausDSNPPlan NameHumana Gold Plus SNP-DE (HMO D-SNP)Plan NumberH5619-038-000Plan HighlightsDual Eligible Special Needs plan forFBDE,QMB ,SLMB . Includes suite of richsupplemental benefits designed for dualmember needs.Dental 1000 annually; 0 copayments covers:exams, x-rays, cleanings, fillings, crowns,extractions, denturesHealthy Foods Card 25 maximum monthly allowance on aHealthy Foods Card for a member to spendtowards the purchase of approved food andbeverage items at participating retailersVisionAnnual exam and 300 credit every year foreyeglasses or contact lenses.HearingAnnual exam, fitting and 2000 credit forhearing aids.OTC Allowance 150 maximum benefit coverage amount perquarter (3 months) for select over-the-counterhealth and wellness products.Transportation 0 copayment for plan approved location upto 36 one-way trip(s) per year by car, van,wheelchair access vehicle.This benefit is not to exceed 50 miles per trip.Current Service AreaSan Joaquin - Stanislaus Market-wideFOR AGENT USE ONLY
California San Joaquin - StanislausPrescription Drug PlansHumana Walmart Value Rx Plan (PDP)Humana Premier Rx Plan (PDP)Humana Basic Rx Plan (PDP)Plan
benefits at Walmart and Humana Pharmacy. Richest formulary and benefits. Preferred benefits at Walmart and Humana Pharmacy. Primarily provides coverage for members with Extra Help (LIS). Tier 1 & Tier 2 mail-order copays are 0 at Humana Pharmacy for 90-day supply. Pairs Well With Humana Med Supp Plan Humana
