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michal
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686e862
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Parent(s):
2880bdc
updates
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summary-of-benefits-paragraphs.txt
CHANGED
@@ -169,32 +169,15 @@ For the retail pharmacy option, for Tier 5 Specialty Tier drugs, the 30-day supp
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Your plan participates in the Insulin Savings Program. You will pay no more than $35 for a one-month (up to a 30-day) supply for Select Insulins, no matter what cost-sharing tier it’s on . To identify which Select Insulins are included within the Insulin Savings Program, look for the ISP indicator in your Prescription
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Drug Guide. You are not eligible for this program if you receive "Extra Help".
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Your plan also provides enhanced insulin coverage which means you will pay no more than $35 for a one-month (up to 30-day) supply for all Part D insulins covered by our plan, including Select Insulins, no matter what cost-sharing tier it’s on . The enhanced insulin coverage is available, even if you receive "Extra
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our network. To find pharmacy mail
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order options, go to
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Humana.com/pharmacyfinder
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Preferred
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CenterWell Pharmacy ™
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- 30-day supply 90-day supply* 30-day supply 90-day supply*
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Tier 3: Preferred Brand $35 $105 $35 $95
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Retail Cost-Sharing for Select Insulins
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Pharmacy
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options
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Retail
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All network retail pharmacies. To find the retail pharmacies near you, go
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to Humana.com/pharmacyfinder
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- 30-day supply 90-day supply*
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Tier 3: Preferred Brand $35 $105
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H1036236000SB23 Summary of Benefits 13
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H1036236000
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If you receive Extra Help for your drugs, you'll pay the following:
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Deductible This plan does not have a deductible.
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Pharmacy cost-sharing
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Your plan participates in the Insulin Savings Program. You will pay no more than $35 for a one-month (up to a 30-day) supply for Select Insulins, no matter what cost-sharing tier it’s on . To identify which Select Insulins are included within the Insulin Savings Program, look for the ISP indicator in your Prescription
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Drug Guide. You are not eligible for this program if you receive "Extra Help".
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Your plan also provides enhanced insulin coverage which means you will pay no more than $35 for a one-month (up to 30-day) supply for all Part D insulins covered by our plan, including Select Insulins, no matter what cost-sharing tier it’s on . The enhanced insulin coverage is available, even if you receive "Extra Help".
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Your share of the cost for Select Insulins depends on whether you choose the Mail Order Cost-Sharing option for Select Insulins or the Retail Cost-Sharing options for Select Insulins.
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There are two mail order cost-sharing pharmacy options, including the Standard option which includes Walmart Mail, PillPack and any other pharmacies that are available in our network. To find pharmacy mail order options, go to Humana.com/pharmacyfinder
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The second cost-sharing pharmacy option is the Preferred CenterWell Pharmacy.
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For the Standard mail order cost-sharing pharmacy option for select insulins, for tier 3 preferred brand insulin drugs the 30-day supply costs $35 and the 90-day supply costs $105.
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For the preferred CenterWell mail order cost-sharing pharmacy option for select insulins, for tier 3 preferred brand insulin drugs the 30-day supply costs $35 and the 90-day supply costs $95.
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For the retail cost-sharing option for buying select insulin drugs, you can got to any in network retailer pharmacies.
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For the retail cost-sharing option for buying select insuling drugs, for the tier 3 preferred brand option the 30-day supply costs $35 and the 90-day supply costs $105.
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If you receive Extra Help for your drugs, you'll pay the following:
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Deductible This plan does not have a deductible.
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Pharmacy cost-sharing
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