The Humana Walmart-Preferred RX Plan is billed as one of the Part D drug plans with the lowest monthly premium.
A low monthly premium is important but, just with any Part D plan, all the moving parts must be taken into consideration to determine a plan’s true cost.
The Humana Walmart branded Part D plan for 2013 has a monthly premium of only $18.50.
In addition to the low monthly premium, it is presumed that the member will also save money when using preferred pharmacies and benefiting from some mail order co-pays of $0.
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Monthly premiums not the whole story
It’s no surprise that a lot of people purchase based on price. This is no different if they are buying groceries, clothing and…. Part D drug plans. Medicare Part D can be overwhelming.
First you have dozens of available plans to choose from and they are all different to some degree or another. It’s easy to just pick the one with the lowest premium and hope for the best. With the Humana Walmart-preferred RX Plan the devil is in the details.
If you use preferred pharmacies you will pay much lower co-pays. Walmart, Sam’s Club and Neighborhood Market Pharmacies are considered preferred pharmacies. After you have met the annual $320 deductible, at preferred pharmacies, you will pay:
- Tier 1 Preferred Generics $1 co-pay
- Tier 2 Generics $3, $4, or $5 co-pay
- Tier 3 Non Preferred Generics and Preferred Brand 20% coinsurance
- Tier 4 Non Preferred Brand 30%- 35% coinsurance
- Tier 5 Specialty 25%
Using the RightSourceRx mail order plan will also result in rich benefits.
So far things are looking pretty good, assuming all your medications are included in the plan formulary and placement of drugs into a specific tier is comparable to what other companies are doing. But the cost of going out-of-network can be a cruel slap.
At non preferred pharmacies you will pay:
- Tier 1 $6- $10 co-pay
- Tier 2 $8-$33 co-pay
- Tier 3 25% coinsurance
- Tier 4 31%-50% coinsurance
- Tier 5 25%
These higher co-pays and coinsurance percentages at non preferred pharmacies can add up quickly and wipe out any savings you may have realized on monthly premiums.
Let me point out that I am not bashing Humana or Walmart, but rather bringing to light the aspects of the Humana Walmart-Preferred RX Plan that you should be aware of before you purchase on price alone.
This is not the only plan available from Humana, and while others may have a higher premium, they offer an expanded formulary and more freedom of choice when choosing a pharmacy.
Who should buy the Humana Walmart plan
This plan will work for many people. If it did not offer value to a certain segment of the market, it wouldn’t exist. Consider this plan if your drugs are included in the formulary and you don’t mind using preferred pharmacies or mail order.
Even with the annual deductible, you may come out ahead, especially if you are able to utilize the RightSourceRx mail order program.
If on the other hand, you require an expanded formulary and you prefer pharmacies that will cost you more, you should compare Medicare Part D drug plans to be certain your drugs are covered.