Humana Medicaid Florida Over The Counter


Some Items Can Be Purchased Only After A Discussion With Your Provider

Humana Florida Medicaid Associates Address Member Concerns During COVID-19

While no prescription is needed before purchasing approved OTC nonprescription drugs and health-related items, some dual-purpose items* can be purchased only after a discussion with your provider. Theyll recommend the right OTC items for a specific diagnosis/condition.

*Dual-purpose items may include:

vitamins, minerals, supplements, herbal and Chinese medicine, hormone replacements, weight loss items, and diagnostic tools like blood pressure monitors.

Dental And Vision Insurance

Dental insurance through Humana is available in three tiers of coverage: Dental Savings Plus, Preventive Value, Dental Preventive Plus. Below is a summary of the costs and benefits of each of these policies:

Plan name
$1,000 $20.99

The main difference between these policies will be the provider networks. Dental Savings Plus may be the cheapest policy among Humana’s offerings but will only provide discounts if you visit in-network dentists. On the other hand, Preventive Value and Preventative Plus will offer more flexibility for networks.

Vision insurance can also be purchased through Humana’s website, but only one plan is offered: Vision Focus Plan. The policy has a monthly premium of $14.99 with a one-time enrollment fee of $35. Humana’s vision insurance will aid you in paying for services such as routine eye exams, contact lenses and frames.

Important Points To Remember

  • Eligible items may be purchased only for the enrollee, not for family members or friends
  • The OTC card is not a debit or credit card and cannot be converted to cash
  • It cannot be used to purchase Part B or Part D prescription drug
  • Any unused balances will automatically expire at the end of each month/quarter or upon disenrollment or transfer to another Healthfirst plan.
  • Please activate your card before using, and to receive your allowance
  • You cannot use your Healthfirst Member ID card or Medicare card to pay for non-prescription drugs, health-related items, healthy foods or produce

OTC items are subject to the plans list of eligible items and the plans participating network of retail and online providers.

Coverage is provided by Healthfirst Health Plan, Inc. Plans contain exclusions and limitations.

Healthfirst Health Plan, Inc. offers HMO plans that contract with the Federal Government and has a contract with New York State Medicaid for its Dual-Eligible Special Needs Plans. Healthfirst Medicare Plan has a contract with New York State Medicaid for Healthfirst CompleteCare and a Coordination of Benefits Agreement with the New York State Department of Health for the Healthfirst Life Improvement Plan . Enrollment in Healthfirst Medicare Plan depends on contract renewal.

Healthfirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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Maximum Limits On Otc Cards

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Depending on your plan, you will receive an OTC card with a maximum limit for purchasing approved OTC nonprescription drugs, health-related items at participating pharmacy locations, and in the case of Life Improvement Plan and CompleteCare, healthy foods and produce items. For more information, view your Evidence of Coverage or contact Member Services.

Plan Details

Do You Have Questions

We are happy to help you. Call Staywell toll-free at 1-866-334-7927 , MondayFriday, 8 a.m.7p.m.

You can visit us too! We have Welcome Rooms throughout the state of Florida. Representatives are there to answer your questions. They can help with things like:

  • Updating your address
  • Changing your Primary Care Provider
  • Ordering over-the-counter items and more

Customer Reviews And Complaints

Humana customer reviews are slightly below average when compared with other health insurance companies. Furthermore, the biggest complaint among members is a slow customer service experience. This is all supported by Humana’s National Association of Insurance Commissioners complaint index rating of 1.82. A rating of close to two indicates that the company receives more complaints than the average given its size.

On the other hand, Humana is an accredited business as seen by the Better Business Bureau , meaning although it has received complaints, the company does actively try to resolve outstanding issues with its policyholders.

Financially, Humana is stable and able to pay customer claims, which can be seen in their A.M. Best rating of A- .

Editorial Note: The content of this article is based on the authorâs opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.

Available Part D Prescription Drug Plans

While many of Humanas Medicare Advantage plans include Medicare Part D drug coverage, the company also sells stand-alone Part D prescription drug plans. These plans, which are meant to accompany Medicare Part A and Medicare Part B, don’t provide medical coverage.

Humana offers three stand-alone prescription drug plans in 2022, with monthly premiums that range from $22.70 to $86.20.

  • Humana Walmart Value Rx Plan: Average monthly premium of $22.77, costs as low as $0 copay and $0 deductible on Tier 1 and Tier 2 drugs, and access to a wide network of pharmacies, including Walmart.

  • Humana Premier Rx Plan: Average monthly premium of $76.65, costs as low as $0 copay and $0 deductible on Tier 1 and Tier 2 drugs, and a broad network of pharmacies.

  • Humana Basic Rx Plan: Average monthly premium of $35.60, prescription deductible of $480 on all tiers. This plan is aimed at members who qualify for Extra Help, who may be able to get the full cost of premiums covered. Extra Help is a Medicare program that offers assistance to people with limited income and resources.

Humana offers three stand-alone prescription drug plans in 2021, with average monthly premiums that range from $17.20 to $72.50:

Otc Food Benefit Card

Update on Free OTC Medicine from Medicare Advantage Plans

In addition to the Over-the-Counter Card Benefit, Kalos Health offers members a pre-paid debit card to purchase healthy food options . It can be used to purchase eligible food items such as fresh fruits and vegetables, milk, bread, eggs. You can find a complete list of eligible items by clicking on this link: Full list of eligible items. You can use this card at the following participating retailers: CVS, Walgreens, Family Dollar, Dollar General, and Walmart. You will a receive gray colored OTC card, similar to the example shown, with a maximum $20 monthly limit for purchasing the approved food items items.

Activating your OTC Food Benefit CardYou must first activate your OTC Food Benefit Card. Call OTC Card Services at 1-888-983-8983 or go online to the OTC Network Website .

To activate your card you will need:1) The card number printed on the front of your OTC Card2) Your Kalos Health Gold Plus Member ID number3) Your Date of Birth

Questions? Call our Member Services Department at 1-800-399-1954 , Monday through Friday, 8:00am to 8:00pm.

How We Reviewed Medicare Providers

Even Medicare health plans with a national presence can vary locally in their cost, quality, and customer satisfaction. To evaluate Medicare plans, we looked at health insurance industry ratings from the primary accrediting agency for health plans, NCQA, and the Medicare Star Ratings from CMS, the regulatory agency that oversees Medicare. We included the National Association of Insurance Commissioners complaint index and AM Bests financial stability ratings. We also considered information from the companies on their programs and strategies.

Humana Walmart Value Rx Plan

Under the Humana Walmart Value Rx Plan, Humana teams up with Walmart, Walmart Neighborhood Markets, and Sams Club pharmacies as its preferred cost-sharing partners.

This lets Humana offer additional prescription savings to people who purchase their medications at Walmart.

The Humana Walmart Value Rx Plans benefits include:

  • $17.20 monthly plan premium nationwide
  • $0 deductible on tier 1 and 2 medications
  • $445 annual deductible on tiers 3 through 5 medications
  • in-store copays as low as $1 on a 30-day supply of certain generic drugs at Walmart, Walmart Neighborhood Markets, and Sams Club
  • copays as low as $3 on a 90-day supply of tier 1 preferred generics through Humanas mail-delivery pharmacy
  • more than 3,500 medications on the plans list of covered drugs

Before choosing the Humana Walmart Value Rx Plan, make sure you live near a Walmart location that features pharmacy services. While you are able to use other pharmacies under this plan, you wont get additional discounts if you dont use Humanas preferred cost-sharing partners.

What States Offer Humana Medicare Advantage Plans

Humana offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska.

Although there is wide availability throughout the country, specific types of plans and coverage options may only be offered in certain areas. This means that if your relative in another state has a Humana plan, the same plan might not be available to you.

Common Examples Of Over

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For some common ailments, such as a cold or headache, OTC drugs may be able to relieve your symptoms while saving you time and money. Talk to your healthcare provider to make certain this is the right choice for you. Below are examples of OTC drugs:

  • Pain relievers: Tylenol®, Advil®, Aleve®, Ibuprofen
  • Cold and flu medications: Sudafed, Mucinex DM
  • Heartburn medications: Tums®, Pepcid AC, Prilosec
  • Allergy medications: Allegra®, Zyrtec®, Claritin

Humana Medicare Advantage 2021

Many or all of the products featured here are from our partners who compensate us. This may influence which products we write about and where and how the product appears on a page. However, this does not influence our evaluations. Our opinions are our own. Here is a list ofour partnersandhere’s how we make money.

Humana is the second-largest provider of Medicare Advantage plans , and the provider thats available to the most people, with plans offered in more than eight out of 10 U.S. counties. The vast majority of its Medicare Advantage customers are in high-quality plans rated 4 stars or higher by the Centers for Medicare & Medicaid Services, and the company offers some nice perks with many plans.

Although most of Humanas Medicare beneficiaries are in high-rated plans, some contracts get lower scores than others, so its worth doing your research before you sign on.

Heres what you should know about Humana Medicare Advantage.

Humana Premier Rx Plan

Like the Walmart Value Rx Plan, the Humana Premier Rx plan also uses Walmart as its preferred cost-sharing partner. This means that living close to a Walmart location is key to saving the most on your prescriptions.

While this plan has a higher premium than the Walmart Value Rx Plan , the Humana Premier Rx Plan includes additional benefits:

  • $0 deductible on tier 1 and 2 medications
  • $0 copay on 90-day supplies of tier 1 and 2 medications from Humanas mail-delivery pharmacy service
  • preferred cost-sharing at Humana Pharmacy, Walmart, Walmart Neighborhood Markets, Sams Club, Publix, Kroger, Harris Teeter, HEB, and Costco pharmacies
  • $445 annual deductible on tiers 3 through 5 medications nationwide and $305 in Puerto Rico
  • more than 3,700 medications on the plans list of covered drugs

Healthfirst Medicare Advantage Plans With An Otc Plus Card

If youre a Healthfirst Medicare Advantage plan member with an OTC Plus card, you have the flexibility to spend your benefit in moreways and at more places.

Use your OTC Plus card to pay for non-prescription drugs, health-related items, healthy foods and even home Internet service.

Save at your neighborhood pharmacy, farmers markets, online and other participating retailers.

Remember to activate your OTC Plus card and bring it with you to participating pharmacies and other retailers as you cannot use your Healthfirst Member ID or Medicare card to purchase OTC items.

Healthfirst Plans with an OTC Plus card:

  • Life Improvement Plan $158/month allowance
  • Connection Plan $270/quarter allowance
  • Any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.

    You must activate your Healthfirst OTC Plus card before you can use it.

    Life Improvement Plan CompleteCare

    Humana Medicare Advantage Service Area

    Humana: How to choose a Medicare Plan that’s right for you

    Humana offers Medicare Advantage plans in 47 states and Puerto Rico, and Medicare prescription drug plans in all 50 states, Washington, D.C., and Puerto Rico. Humana Medicare Advantage plans are available in 85% of U.S. counties the most of any provider.

    For the 2022 plan year, Humana expanded its HMO offerings into 115 new counties and introduced local PPO plans in 162 new counties. The company also expanded D-SNPs into 268 new counties .

    Overall, Humana is the second-largest health insurer among for-profit health plans . Nearly 4.9 million Medicare beneficiaries are enrolled in a Humana Medicare Advantage plan.

    Available Humana Medicare Advantage Plans

    Humana offers several kinds of Medicare Advantage plans, and they vary in terms of structure, costs and benefits available. Many plans offer dental and vision benefits, worldwide emergency care, and fitness benefits through SilverSneakers.

    In general, Humana offers Medicare Advantage Prescription Drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage Plans without drug coverage. Its also worth noting that Humana Honor, the companys Medicare Advantage plan thats aimed toward U.S. military veterans, has been expanded into 47 states in its third year of operation.

    Other plan offerings include the following types:

    A health maintenance organization generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

    Preferred provider organization plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you dont need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

    Humanas private fee-for-service plans allow you to see any Medicare-approved provider who accepts your Humana plan. You wont have to pick a primary doctor, and you wont need a referral to see a specialist.

    Humana Expanding Medicare Advantage Health Plans In 2022 To Address Beneficiaries Most Important Needs Delivering Predictable Affordable And Understandable Health Care

    Beneficiaries can enroll with Humana virtually or meet agents in person its up to each individual

    Humana Medicare plans are recommended by USAA

    LOUISVILLE, Ky.—-Humana Inc. today announced details of its 2022 Medicare product offerings, including many Medicare Advantage and Prescription Drug Plans that are built to address the needs of diverse populations and people eligible for Medicare who are challenged by critical social determinants of health such as food security and access to transportation for medical services. Beneficiaries will have new choices through the launch of 72 new plans 42 Non-SNP MAPD, 3 MA Only, and 27 Special Needs Plans across hundreds of additional U.S. counties.

    As the COVID-19 pandemic continues, the health and safety of Humana employees, customers and business partners is the companys top priority. Humana will once again offer online and telephonic enrollment options in addition to safe in-person sessions for enrollees who prefer to sign up in person to protect beneficiaries as they explore their health care options during the fall 2021 Medicare Annual Election Period, which runs from Oct. 15 through Dec. 7, 2021.

    Additional Highlights of Humanas 2022 Medicare Advantage and Prescription Drug Plans

    • For all MAPD members, benefits continue to include $0 telehealth copays for primary care physician visits, urgent care and outpatient behavioral health.

    Medicare Advantage Plans

    Stand-Alone Prescription Drug Plans

    For More Information

    Personal Emergency Response Systems

    Life Improvement Plan members only: Order a PERS through which provides peace of mind knowing that help is available at a push of a button. Each emergency response system is powered by ADT, one of the nations leading providers of security, automation, and safety solutions. The system includes two-way communication to ADT monitoring centers, water resistant wristband and pendant options, and 24/7/365 monitoring services by ADT special senior sensitivity trained monitoring professionals.

    Some CompleteCare members may qualify for PERS without using their OTC Plus card. Contact Member Services to see if youre eligible.

    Competition: Humana Vs Unitedhealthcare

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    Humana and UnitedHealthcare are the Medicare Advantage plans with the broadest geographical coverage 84% of counties have Humana options, 66% have UnitedHealthcare, and 60% have both. UnitedHealthcare is the nations largest health insurer, with more than 14% market share.

    UnitedHealthcare also has an exclusive partnership with AARP, giving it a unique advantage in a trusted brand affiliation. UnitedHealthcare has slightly higher average Star Ratings, but both companies offer online tools or apps and multiple channels for customer support. UnitedHealthcare helps members choose a plan with customized recommendations and cost estimators.

    In a head-to-head comparison, the difference may come down to specific quality ratings in your local area and cost, which vary depending on where you are.


    Humana has deep roots in care for older Americans. They offer a wide range of Medicare plans in the broadest geography of any insurer. Not only one of the biggest Medicare plans, Humana is one of the highest-rated overall. Not all their subsidiaries score as well for quality or customer satisfaction, so verifying the ratings of your specific options is important.

    They also offer a range of ways to sign up and interact with the plan. Humana offers many extra benefits along with health and wellness programs.

    Step : Pay At The Front Of The Store

    Gather your eligible items and proceed to the front of the store checkout lanes. When you check out, swipe the card for payment.

    The total amount that you spend will be taken out of your monthly balance. Eligible items up to $120 per month will be covered. Any remaining balance at the end of the month is lost and will not carry over to the next month.


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