March 18, 2010

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Humana – Portrait Share 80 Plus Rx Unlimited – ALABAMA

A comparison of the Portrait Share 80 Plus Rx Unlimited offered by Humana is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Network See Provider See Provider
Application Portrait Share 80 Plus Rx Unlimited Application Portrait Share 80 Plus Rx Unlimited Application
Brochure Portrait Share 80 Plus Rx Unlimited Brochure Portrait Share 80 Plus Rx Unlimited Brochure
Copay
  • Primary Care (unlimited visits): $35 copayment. Specialty Care (unlimited visits): $50 copayment.
    		•  N/A
    Office Visit
  • Primary Care (unlimited visits): $35 copayment. Specialty Care (unlimited visits): $50 copayment.
    		•  60% after deductible
    Deductible Individual: $1,000, Family: $2,000 (Two family members must each meet their individual deductible) Individual: $2,000, Family: $4,000 (Two family members must each meet their individual deductible)
    Coinsurance 80% 60%
    Coinsurance Limit Portrait Share 80 Plus Rx Unlimited Portrait Share 80 Plus Rx Unlimited
    Out-of-Pocket Maximum Individual: $2,000, Family: $4,000 (Per calendar year, deductibles and copayments to not apply) Individual: $8,000, Family: $16,000 (Per calendar year, deductibles and copayments to not apply)
    Lifetime Maximum $5,000,000 per covered person $5,000,000 per covered person
    Prescription Drugs
  • $500 prescription drug deductible per individual.
  • 100% after Copayments (up to 30-day supply):
    • Level One (lowest copayment for lowest cost generic and brand-name drugs)- $15 copayment is not subject to prescription drug deductible.
    • Level Two (higher copayment for higher cost generic and brand-name drugs)- $35 copayment after prescription drug deductible.
    • Level Three (higher copayment than Level Two for higher cost, mostly brand-name drugs that may have generic or therapeutic equivalents in Levels One or Two)- $55 copayment after prescription drug deductible.
    • Lever Four (highest copayment for high-technology drugs)- 25% copayment after prescription deductible up to $2,500 maximum out-of-pocket per calendar year.
  • Mail Order (90-day supply)- 100% after three times the retail copayment.
    		•
  • $500 prescription drug deductible per individual.
  • 70% after Copayments (up to 30-day supply):
    • Level One (lowest copayment for lowest cost generic and brand-name drugs)- $15 copayment is not subject to prescription drug deductible.
    • Level Two (higher copayment for higher cost generic and brand-name drugs)- $35 copayment after prescription drug deductible.
    • Level Three (higher copayment than Level Two for higher cost, mostly brand-name drugs that may have generic or therapeutic equivalents in Levels One or Two)- $55 copayment after prescription drug deductible.
    • Lever Four (highest copayment for high-technology drugs)- 25% copayment after prescription deductible up to $2,500 maximum out-of-pocket per calendar year.
  • Mail Order (90-day supply)- 70% after three times the retail copayment.
    		•
    Emergency Room 80% after $75 copayment per visit and deductible (copayment waived if admitted). 60% after $75 copayment per visit and deductible (copayment waived if admitted).
    Adult Preventative Care Portrait Share 80 Plus Rx Unlimited Portrait Share 80 Plus Rx Unlimited
    Child Preventative Care Portrait Share 80 Plus Rx Unlimited Portrait Share 80 Plus Rx Unlimited
    Lab / X-Ray Portrait Share 80 Plus Rx Unlimited Portrait Share 80 Plus Rx Unlimited
    Maternity Pregnancy Complications and Sick Baby Services (No prior authorization required): 80% after deductible Pregnancy Complications and Sick Baby Services (No prior authorization required): 60% after deductible
    Physical Therapy N/A N/A
    Skilled Nursing 80% after deductible (Up to 30 days admission, prior authorization required in order to be eligible for these benefits) 60% after deductible (Up to 30 days admission, prior authorization required in order to be eligible for these benefits)
    Home Health Care 80% after deductible (up to 60 days per calendar year). 60% after deductible (up to 60 days per calendar year).
    Mental Health
  • Inpatient and Outpatient care (Combined $2,500 per calendar year maximum.
  • Outpatient care not to exceed $500 of the $2,500 calendar year maximum.)- 50% after deductible.
    		•
  • Inpatient and Outpatient care (Combined $2,500 per calendar year maximum.
  • Outpatient care not to exceed $500 of the $2,500 calendar year maximum.)- 50% after deductible.
    		•
    Hospital Care 80% after deductible 60% after deductible
    Optional Benefits Dental
  • Maternity
  • Prescription drug, no deductible
  • Lifetime maximum benefit
  • $500 Supplemental Accident Benefit
  • $1,000 Supplemental Acciden
    		•  Dental
  • Maternity
  • Prescription drug, no deductible
  • Lifetime maximum benefit
  • $500 Supplemental Accident Benefit
  • $1,000 Supplemental Acciden
    		•