Humana Pharmacy Solutions: Pinellas County Schools 2013 Plan BenefitsUnderstanding Your Pharmacy Benefits

Your pharmacy benefit Pages 3-4

For your safety Pages 5-8

Filling your prescriptions Pages 9-15

Maximizing your pharmacy benefits Pages 16-17

Humana web and mobile tools Pages 18-25

Questions to ask your doctor Pages 26-27

2

Contents

Your Rx3 Plan assigns prescription drugs into three levels of coverage. Level 1: generic drugs Level 2: preferred brand-name drugs Level 3: non-preferred brand-name drugs and specialty drugs

3

Understanding your Rx3 Plan

Prescription Drug Level

Prescription Deductible Wal-Mart or CVS RightSource

Mail Order

Deductible only on Tiers 2 & 3

30 day supply

90 day supply

90 day supply

Tier 1 N/A $15 copay $30 copay $30 copay

Tier 2 $250 per individual/$500

per family

$35 copay $70 copay $70 copay

$60 copay $120 copay $120 copayTier 3

A committee of Humana pharmacists and doctors evaluate each drug after the U.S. Food and Drug Administration has approved them. This is also done once a year for maintenance.– The committee looks at medical research and literature to decide how the drug

compares to similar products on the market in such areas as:• Effectiveness• Safety• Side effects• Drug interactions• Cost

This helps to ensure you get medicines that are safe, effective, and at an affordable cost.

4

How levels are assigned

5

For your safety- Prior Authorization

6

For your safety- Quantity Limits

7

For your safety- Step Therapy

Because they’re the same: Dosage Safety Strength Quality Performance

They save you money They contain the same active ingredient as the

brand-name drug but are usually 30 to 80 percent less than their brand name counterparts.

8

Why Generics?

Always use a pharmacy that is in the Pinellas County Public Schools pharmacy network. Those pharmacies are Walmart, Sam’s Club, CVS, RightSource and RightSource Specialty.

Networks are groups of pharmacies that agree to give discounted prices to members of certain pharmacy plans.

*Don’t forget to show your Humana member ID card!

9

Filling your prescriptions

RightSource & RightSource Specialty

Humana's Mail Order and SpecialtyPharmacies

10

RightSource is Humana’s Mail-Order pharmacy.‒ RightSource fills prescriptions for maintenance medications.

• Maintenance medications are taken regularly and long-term for conditions such as: asthma, high cholesterol, and high blood.

RightSource Specialty is Humana’s Specialty pharmacy.– RightSource Specialty fills prescriptions for specialty medications.

• Specialty medications are used to treat chronic, complex illnesses and are typically high-priced injectable drugs. But can also include expensive tablets, capsules or inhaled medications.

These are separate pharmacies that fill different types of prescriptions and operate out of different locations.– If you use both pharmacies, you’ll receive individual invoices and shipments will

arrive separately.

11

RightSource & RightSource Specialty

12

Why RightSource?

13

Your RightSource experience

RightSource receives the prescription order. – Doctors can send new prescriptions by fax, phone, or electronically.– You can send new prescriptions by mail with an order form or visit your

claims page on MyHumana to transfer an existing prescription.

RightSource technicians – Check the Humana pharmacy benefits coverage– Add the profile to a secure database– Scan the order– Create a unique shipment number

Doctor’s instructions and prescription orders are loaded into RightSource computers.

A RightSource pharmacist reviews the prescription order for accuracy and possible drug interactions. If there are concerns or questions, a RightSource pharmacist contacts the doctor for clarification.

14

Your RightSource experience

Approved orders go through the payment process. – If for some reason your benefit doesn’t cover the medication, a technician will

review the rejected claim.– RightSource will resolve the issue or return the written prescription with an

explanation about why they couldn’t process it.

An automated system dispenses the medication and a RightSource pharmacist makes sure the product matches the label before it’s sealed.

RightSource mails the order to your home, along with an invoice, and all of the necessary medication information.

RightSource Specialty pharmacists are available 24 hours a day, seven days a week to answer questions and listen to concerns.

Members receive a 30-day supply delivered to their home or doctor’s office, along with any required administrative supplies such as needles or syringes.

Every new patient is contacted by a nurse.– Nurses specialize in the patient’s condition and medications.– The patient’s condition is assessed and a follow-up outreach is determined.– Patients are provided with nurse contact information and may call as often as

needed.

Learn more online at RightSourceRx.com/Specialty

15

RightSource Specialty

16

Maximizing your pharmacy benefits

Publix Not a network pharmacy, so no need to

show your Humana card, but you can still get these medications for FREE Lisinopril (blood pressure medication) Metformin (diabetes medication) Certain Antibiotics such as:

Amoxicillin Ampicillin Cephalexin (capsules and suspension only) Sulfamethoxazole/trimethoprim (SMZ-TMP) Ciprofloxacin (excluding Ciprofloxacin XR) Penicillin VK Doxycycline Hyclate (capsules only)

For more information including limitations please visit http://www.publix.com/pharmacy/Free-Medications.do

17

Want cheaper or free medications?

Walmart $4 prescriptions: (on a 30 day supply) Always show your Humana card at Walmart, and

when you choose medications from this list your generic copay is only $4 instead of your regular $15 generic copay!

For a full list of these medications please visit: http://www.walmart.com/cp/PI-4-Prescriptions/1078664

Humana Web and Mobile Tools

18

What is MyHumana? It’s Humana’s secure website that gives you access to your information anytime you want it.

If you haven’t registered for MyHumana:1. Visit www.MyHumana.com

2. Have your Humana ID card handy

3. Go to Humana.com

4. Click “Register for MyHumana”

5. Follow the easy steps to register

19

24- Hour online pharmacy resources

20

MyHumana is Your Humana

Select the Wal-Mart or CVS pharmacy locations based on address and/or zip code.

View pharmacy information (24 hour location, drive-thru, 90 days at retail, etc.).

21

Pharmacy locator

Locate drug level and copay amount. Find generic or lower cost alternatives. Please find the coverage information on your drug in the highlighted areas

below.

22

Drug pricing tool on MyHumana

23

Pharmacy claims information

24

Switching to RightSource is easy

• You can:– Determine if plan covers prescriptions– Find prices at RightSource and retail pharmacies– Identify alternatives– Sign up for text message refill reminders

• Available in:– Android Store– iTunes– Mobile device browser at m.humana.com

• Future enhancements:– Medication adherence alerts– Biometric monitoring– Order RightSource refills at the click of a button

25

MyHumana Mobile

Questions to ask your doctor or pharmacist

26

• How will this medication help me?

• How long should I stay on this medicine?

• Is there anything I shouldn’t take while I’m on this medication?

• What side effects can I expect?

• Is there a generic available?

27

Questions

Humana Pharmacy Solutions

28