Retail Cost-Sharing 
Pharmacy options Standard All other network retail 
pharmacies.  Preferred 
To find the preferred cost-share 
retail pharmacies near you, go to  
Humana.com/pharmacyfinder  
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 $3 
Tier 3: Preferred Brand 23% 23% 19% 19% 
Tier 4: Non-Preferred 
Drug 45% 45% 41% 41% 
Tier 5: Specialty Tier 25% N/A 25% N/A