Summary of Benefits SBOSB045 
Humana Basic Rx Plan (PDP) S5884-138 
States of Indiana and Kentucky 
Our service area includes the following state(s): Indiana, Kentucky. 2023 
GNHH4HIEN_23_C Summary of Benefits S5884138000SB23 Pre-Enrollment Checklist 
Before making an enrollment decision, it is important that you fully understand our benefits and rules. If you 
have any questions, you can call and speak to acustomer service representative at  1-800-706-0872 (TTY: 
711) .
Understanding the Benefits