Humana at North Carolina State Health Plan

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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 outlines the 2026 Medicare health benefits and services for members of the NC State Health Plan Humana Group Medicare Advantage PPO Base Plan. It details coverage, costs (including copayments and coinsurance), rights, and responsibilities for the plan year from January 1, 2026, to December 31, 2026. Key aspects covered include medical benefits, filing complaints, appeals processes, network and out-of-network provider usage, and special provisions for emergencies and other situations. The plan's maximum out-of-pocket amount for covered Medicare Part A and B services is $4,000.00.

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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 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.