drug costs paid by both you and our plan. Once you reach this amount, you will enter the Coverage Gap. 
Mail Order Cost-Sharing 
Pharmacy options Standard  
Walmart Mail ,PillPack 
Other pharmacies are 
available in our network. To find 
pharmacy mail order options go to  
Humana.com/pharmacyfinder Preferred 
CenterWell Pharmacy ™
N/A 30-day supply 90-day supply* 30-day supply 90-day supply* 
Tier 1: Preferred Generic $1 $3 $0 $0 
Tier 2: Generic $2 $6 $1 $0 
Tier 3: Preferred Brand 23% 23% 19% 15%