Humana Insurance Company at North Carolina State Health Plan

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This document outlines the 2026 Medicare Prescription Drug Coverage for members of the NC State Health Plan Humana Group Medicare Base PDP Plan. It details benefits, premiums, cost-sharing for Part D drugs, member rights and responsibilities, complaint and appeal processes, and conditions for ending membership. The coverage is effective from January 1, 2026, to December 31, 2026.

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This document details the Medicare health benefits and services for members of the NC State Health Plan Humana Group Medicare Advantage PPO Enhanced Plan for the calendar year 2026, effective from January 1, 2026, to December 31, 2026. It outlines plan premiums, member cost-sharing for various medical services, maximum out-of-pocket limits ($3,300.00), and rules for network and out-of-network providers. It also covers member rights, responsibilities, and procedures for complaints and appeals related to coverage decisions and quality of care. The plan is offered by Humana and facilitates Medicare Part A and B services.

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This Evidence of Coverage document details the Medicare Prescription Drug Coverage for the NC State Health Plan Humana Group Medicare Enhanced PDP Plan for the 2026 plan year. It specifies benefits, rights, eligibility requirements, drug coverage rules, cost-sharing amounts, and procedures for complaints and appeals. The plan is active from January 1, 2026, to December 31, 2026, and is offered by Humana.

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This document provides a comprehensive comparison of the 2026 State Health Plan options for Medicare Primary Subscribers, featuring Humana Medicare Advantage (Enhanced and Base Plans) and the 70/30 PPO Plan. It details various cost-sharing aspects such as annual deductibles, out-of-pocket maximums, and copayments/coinsurance for medical services like hospital stays, doctor visits, and emergency care, as well as pharmacy benefits for retail and maintenance drugs across different tiers.