Each covered person must complete a separate, three-part paper enrollment form and mail it to Humana in order to enroll for coverage for the first time only. If you are already enrolled, you do not need to take any special action to re-enroll in 2012.
The Freescale medical plan for retirees age 65 and older – those who are also covered by Medicare – is the Humana Group Medicare Preferred Provider Organization (PPO). If you have questions about this plan, please call the special Humana line dedicated to this plan: 800-733-6592. Because this plan is offered through a Humana insurance contract, questions about it can be answered only by a Medicare-licensed insurance company representative until your coverage begins.
2012 PPO Enrollment Guide
This booklet was mailed to eligible grandfathered and nongrandfathered
participants in October 2011.
Humana Prescription Drug Formulary 2012
This booklet lists the most commonly-prescribed prescription drugs covered by both the grandfathered and nongrandfathered Humana Group Medicare PPO Plan. It shows the available dosages and coverage level (tier) to which each drug is assigned, as well as any limitations or restrictions on their use.
Prescription Drug Schedule 2012
A shorter, simpler explanation of your prescription drug benefits, to supplement the formulary booklet.
RightSource Registration Order Form
A brochure and order form to buy prescription maintenance medicines by mail.
2012 Documents for Download – Grandfathered
Summary of Benefits – Grandfathered
A summary of your grandfathered benefits under the Humana Group Medicare PPO Plan.
Grandfathered Evidence of Coverage
This legal document gives the details about your medical coverage and explains how to get the care you need.
Summary of Benefits – Nongrandfathered
A summary of your nongrandfathered benefits under the Humana Group Medicare PPO Plan.
Nongrandfathered Evidence of Coverage
This legal document gives the details about your medical coverage and explains how to get the care you need.
Useful Phone Numbers and Web Sites
Humana: For all age 65+ medical coverage, including prescription drugs and behavioral health care.
