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Plans not available in all areas. Costs, coverage, and benefits vary by
location.

Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone
prescription drug plan with a Medicare contract. Humana is also a Coordinated
Care plan with a Medicare contract and a contract with the state Medicaid
program. Enrollment in any Humana plan depends on contract renewal.

Humana Inc. and its subsidiaries (collectively, “Humana”) comply with applicable
Federal civil rights laws and do not discriminate on the basis of race, color,
national origin, age, disability, sex, sexual orientation, gender identity or
expression, transgender status, marital status, military or veteran status, or
religion. Humana does not exclude people or treat them differently because of
race, color, national origin, age, disability, sex, sexual orientation, gender
identity or expression, transgender status, marital status, military or veteran
status, or religion. We also provide free language interpreter services. See our
full accessibility rights information and language options.

Florida residents: FL Dual-Eligible Special Needs Plans are sponsored by Humana
and the State of Florida, Agency For Health Care Administration.

Tennessee residents: NOTICE: TennCare is not responsible for payment for those
benefits offered by TN Dual-Eligible Special Needs Plans, except for appropriate
cost sharing amounts. TennCare is not responsible for guaranteeing the
availability or quality of these benefits. Any reference to more, extra, or
additional Medicare benefits, is applicable to Medicare only and does not
indicate increased Medicaid benefits.

Ohio residents: For the Humana Cleveland Clinic Preferred HMO and D-SNP plans,
other ancillary providers such as labs and durable medical equipment suppliers,
and pharmacies are available in our network.

Other Pharmacies/Physicians/Providers are available in our network.

Humana’s pharmacy network includes limited lower-cost, preferred pharmacies in
urban areas of AL, CA, CT, DC, DE, GA, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO,
MS, MT, NC, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV,
WY; suburban areas of AZ, CA, CT, DC, DE, HI, IA, IL, IN, MA, MD, ME, MI, MN,
MO, MT, ND, NH, NE, NJ, NY, OH, OR, PA, PR, RI, SD, VT, WA, WV, WY; and rural
areas of AK, IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited
number of preferred cost share pharmacies in urban areas in the following
states: CT, DE, MA, MD, ME, MI, MN, MS, NC, ND, NY, OH, RI, SC, VT, WA; suburban
areas of: MT and ND; and rural areas of: ND. The lower costs advertised in our
plan materials for these pharmacies may not be available at the pharmacy you
use. For up-to-date information about our network pharmacies, including whether
there are any lower-cost preferred pharmacies in your area, please call Customer
Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at
Humana.com.

Limitations on virtual visit healthcare and prescription services delivered via
remote access technology and communications vary by state. Virtual visit
services are not a substitute for emergency care and are not intended to replace
your primary care provider or other providers in your network. This material is
provided for informational use only and should not be construed as medical
advice or used in place of consulting a licensed medical professional.

Out-of-network/non-contracted providers are under no obligation to treat Humana
members, except in emergency situations. Please call our customer service number
or see your Evidence of Coverage for more information, including the
cost-sharing that applies to out-of-network services.

Enrollees must continue to pay their Medicare Part B premium, their Humana plan
premium, and their Optional Supplemental Benefit (OSB) premium.
Y0040_GHHL854EN_2022
Last Updated: 11/8/2021
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