2027 Benefit Information: Medicare Members
2027 Benefit Information: Medicare Members
As a Medicare-eligible member, you continue to have three plan options to choose from in 2027:
- Humana Medicare Advantage PPO & Prescription Drug Base Plans
- Humana Medicare Advantage PPO & Prescription Drug Enhanced Plans
- The 70/30 Plan, administered by Aetna
If you are currently enrolled in a Humana Medicare Advantage Plan, you WILL REMAIN in that plan for 2027 and do not need to take action during Open Enrollment unless you want to be enrolled in a different plan or if you need to make any changes regarding your dependents.
You needed to TAKE ACTION during Open Enrollment if you are enrolled in the 70/30 Plan and did NOT want to be enrolled in the Humana Medicare Advantage Base PPO & Prescription Drug Base Plans or if you needed to make changes regarding your dependents.
2027 Informational Video
How to Use the Find a Doctor Tool
2027 Humana Resources
- 2027 Humana Base Plan Summary of Benefits
- 2027 Humana Base Prescription Drug Plan Summary of Benefits
- 2027 Humana Enhanced Plan Summary of Benefits
- 2027 Humana Enhanced Prescription Drug Plan Summary of Benefits
- 2027 Comprehensive Formulary
- 2027 Abbreviated Prescription Drug Guide
- 2027 Humana Base Plan Annual Notice of Changes
- 2027 Humana Enhanced Plan Annual Notice of Changes
- 2027 Humana PDP Base Plan Annual Notice of Changes
- 2027 Humana PDP Enhanced Plan Annual Notice of Changes
- 2027 Humana Base Plan Evidence of Coverage
- 2027 Humana Enhanced Plan Evidence of Coverage
- 2027 Humana PDP Base Plan Evidence of Coverage
- 2027 Humana PDP Enhanced Plan Evidence of Coverage
- Humana Website
Humana Group Medicare Advantage (PPO) Plan Highlights
- You will receive ONE ID CARD for both medical and pharmacy benefits. You no longer need 2 separate ID cards.
- You will continue to receive 2 Annual Notices of Change and other duplicated CMS required notices.
- There have been changes to specialist visit copays, hospital stay copays, imaging services, Part B drug copays and annual out-of-pocket maximums.
The 70/30 Plan, administered by Aetna Highlights
- This plan will include a new three-tiered network for 2027, which means the provider you see may impact your out-of pocket costs.
- Medicare will remain primary and work the same as it does today, but your out-of-pocket cost may vary based on the tier level of your provider.
2027 70/30 Plan Resources
CVS Caremark is the State Health Plan’s Pharmacy Benefit Manager.
The State Health Plan utilizes a custom, closed formulary (drug list). The formulary indicates which drugs are excluded from the formulary and not covered by the Plan. All other drugs that are on the formulary are grouped into tiers. Your medication’s tier determines your portion of the drug cost.
These documents and tools include information based on the 2026 formulary and are subject to change prior to January 1, 2027. Please note: Pharmacy copays and out-of-pocket costs accumulate to the Access Tier deductible/out-of-pocket maximum.