Humana Health Care Plans with Prescription Drug Coverage

MSU has partnered with Humana to provide a retiree health care plan with prescription drug coverage.

Who is Eligible

The following populations are eligible for the Humana plans:

• MSU retirees eligible for Medicare (age 65+)
• MSU retirees not yet eligible for Medicare (age 64 and under)
• MSU retiree dependents eligible for Medicare
• MSU retiree dependents not yet eligible for Medicare
• MSU employees not actively working due to workers compensation, long-term disability, or other reasons that are eligible for Medicare, and their associated dependents
• MSU active employees with End Stage Renal Disease (ESRD) who have been enrolled in Medicare for longer than 30 months

Important Note: Retirees with an international permanent or mailing address are not eligible for the Humana plans; however, MSU now offers the Cigna Global Health plan for individuals living abroad. Learn more here.

The Humana Group Medicare Advantage Preferred Provider Organization (PPO) Plan

Visit the Humana website for plan information.

The Humana Group Medicare Advantage PPO Plan contains medical and prescription drug coverage.

Medical Coverage:

The plan covers all preventive services at 100%. Selected services are covered at 96%-100% after the required annual deductible of $192 per member; however, not all services are subject to the deductible. Participants should refer to the type of service for benefit details. The annual out-of-pocket maximum is $1200 per member, per calendar year (excludes Part D Pharmacy, Extra Services and the Plan Premium).

• If enrolled, you can choose any provider who accepts Medicare and agrees to bill the plan but you may save money by using providers from Humana’s large provider network.
• You are not required to have a referral to see any provider.
• You have access to wellness tools and resources to help you reach your personal health goals.

Prescription Drug Coverage:

Prescription drug coverage is included in this plan. The table below shows co-pay rates for various types of prescription drugs:

Prescription Plan Co-Pays for Humana Group Medicare Advantage PPO Plan
#	Drug Tier	30-Day Supply Co-Pays at Retail	90-Day Supply Co-Pays at Retail	90-Day Supply Co-Pays at Mail Order or MSU Pharmacy
1.	Generic Medications	$10	$20	*$20
2.	Preferred Brand-Name Medications	$30	$60	$60
3.	Non-Preferred Brand-Name Medications	$60	$120	$120
4.	Specialty Drugs	$75	**N/A	**N/A
Annual Out-of-Pocket Co-Pay Maximum: Individual $1000

*Some generics may be on higher tiers.

**Specialty medications limited to a 30-day supply.

The Humana MSU Non-Medicare PPO Plan

Visit the Humana website for plan information.

Medical Coverage:

The plan covers in-network preventive services at 100%. The majority of the in-network diagnostic services are covered at 100% of the approved amount after either the required co-payment or annual deductible of $100 for single and $200 for family. Select in-network services are covered at 50%-90% of the approved amount after the required in-network annual deductible, however, not all services are subject to the deductible. Participants should refer to the type of service for benefit details. The annual out-of-pocket maximum, which consists of applicable deductible and co-insurance, is $3000 for single and $6000 for family, per calendar year.

The plan also covers out-of-network services. The majority of out-of-network preventive and diagnostic services are covered at 80% of the approved amount after the required out-of-network annual deductible of $500 for single and $1000 for family. Select out-of-network services are covered at 50% of the approved amount after the required out-of-network annual deductible. Participants should refer to the type of service for benefit details. Participants may be responsible for the amount that exceeds the approved amount in addition to their deductible or co-insurance. The annual out-of-network out-of-pocket maximum, which consists of applicable co-insurance only, is $3000 for single and $6000 for family, per calendar year.

• You will have access to Humana’s large network of physicians.
• You are not required to have a referral to see any provider.

Prescription Drug Coverage:

Prescription drug coverage is included in this plan. The table below shows co-pay rates for various types of prescription drugs:

Prescription Plan Co-Pays for Humana MSU Non-Medicare PPO Plan
#	Drug Tier	30-Day Supply Co-Pays at Retail	90-Day Supply Co-Pays at Retail	90-Day Supply Co-Pays at Mail Order or MSU Pharmacy
1.	Generic Medications	$10	$30	$20
2.	Preferred Brand-Name Medications	$30	$90	$60
3.	Non-Preferred Brand-Name Medications	$60	$180	$120
4.	Specialty Drugs	$75	*N/A	*N/A
Annual Out-of-Pocket Co-Pay Maximum: Individual $1000 AND Family $2000

*Specialty medications limited to a 30-day supply.

Additional Information and Resources

Enrollment Materials

• 2024 MSU Retiree Open Enrollment Guide

In addition, eligible participants received an Enrollment Kit from Humana with further details and instructions.

Frequently Asked Questions (FAQs)

View a list of FAQs here.

Contact Information

If you have questions regarding eligibility and enrollment, contact the HR Solutions Center at 517-353-4434, 800-353-4434 or SolutionsCenter@hr.msu.edu.
If you have questions about plan coverage, contact Humana at 800-273-2509.