Humana Basic Rx Plan (PDP) offers apharmacy 
network with preferred cost sharing at select 
pharmacies. You may pay more at other 
pharmacies. 
Ahealthy partnership 
Get more from your plan —with extra 
services and resources provided by 
Humana! 6 Summary of Benefits S5884138000SB23 S5884138000 
Monthly Premium, Deductible and Limits 
Monthly Plan Premium $30.70 
If you receive premium assistance, your plan premium may be 
reduced. 
If you have Part B, you must keep paying your Medicare Part B 
premium.