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Verified against CMS.gov · on April 2026 Plan ID: S5884-171 Cross-check on Medicare.gov →

Humana Premier Rx Plan (PDP)

Plan Year 2026
$103.70 /month
Monthly Premium
$0.00 Annual Deductible
882 Drugs Covered
0 States Served

Top Covered Drugs

Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.

# Drug Name Type Tier 30-Day Copay
1 Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 4 0.5% coinsurance Details
2 SOMAVERT pegvisomant Brand Tier 5 0.3% coinsurance Details
3 Tacrolimus Brand Tier 4 0.5% coinsurance Details
4 Metoclopramide Brand Tier 1 $0.00 Details
5 Fiasp insulin aspart injection Brand Tier 3 $45.00 Details
6 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 0.5% coinsurance Details
7 Clozapine Brand Tier 4 0.5% coinsurance Details
8 RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent Brand Tier 1 $0.00 Details
9 Amoxicillin Brand Tier 1 $0.00 Details
10 Phenobarbital Brand Tier 3 $45.00 Details
11 RETEVMO selpercatinib Brand Tier 5 0.3% coinsurance Details
12 Medroxyprogesterone Acetate Brand Tier 2 $4.00 Details
13 Cobenfy xanomeline and trospium chloride Brand Tier 4 0.5% coinsurance Details
14 Xalkori CRIZOTINIB Brand Tier 5 0.3% coinsurance Details
15 Venlafaxine Hydrochloride Brand Tier 2 $4.00 Details
16 Everolimus Brand Tier 5 0.3% coinsurance Details
17 Primaquine Phosphate Brand Tier 3 $45.00 Details
18 Acarbose Brand Tier 1 $0.00 Details
19 Gilotrif afatinib Brand Tier 5 0.3% coinsurance Details
20 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 3 $45.00 Details

Showing 20 of 882 covered drugs.

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