The Humana Walmart Preferred Rx Premium is again the lowest Medicare Part D premium
When Humana and Walmart teamed up their goal was to offer a low cost Medicare Part D drug plan. The 2017 Part D premium for the Humana Walmart Preferred Rx Plan is again the lowest this year.
The Humana Walmart Rx plan has a monthly premium of just $17.00 per month. The annual deductible is $400 but does not apply to generics when using a preferred pharmacy.
Using preferred pharmacies in the Humana – Walmart network can save you even more money. Preferred pharmacies include; Walmart, Sam’s Club and Neighborhood Market. Some Humana members using the Right Source home delivery service will have no co-pays for some medicines.
f you are comparing Part D plans, the Humana Walmart-Preferred RX Plan deserves a look.
Comparing Humana Part D plans
When comparing Medicare Part D plans, price is not always the barometer that indicates a good value.
It certainly helps if the plan is affordable but the most important factor is whether or not your drugs are included in the plan’s formulary.
The lowest price will not do you any good unless you can get the drugs your doctor has prescribed.
Humana’s Other Part D Plans Include:
Humana Enhanced PDP
Humana Preferred PDP
Both the formularies and the monthly premiums will vary greatly depending on the plan chosen. Part D is offered State by State and premiums and benefits may vary.
If you are comparing Humana Part D plans and are considering the Humana Walmart-Preferred RX Plan, it would be wise to request the plan’s formulary guide.
You can also go online and view a list of all covered drugs in each Humana Part D plan.
If your medications are not covered, the lowest Part D premium will not do you any good.
Humana is going to have the cheapest PDP on the market for 2011, but it is essential that the plan will cover your drugs. Humana is going to use separate formularies for each of their 3 PDP’s. Please be aware of this when considering their plans.
Adam, You make an excellent point. Whether you are comparing a Humana 2011 Part D plan, AARP Part D plan for 2011 or any other Part d coverage, it is recommended that you review the plan’s formulary before you enroll. Like wise with a $0 premium Medicare Advantage plan… always review the provider directory to ensure that your providers participate. Thanks for the excellent post.
It’s pure bait and switch by the Master of bait and switch Humana. How quickly we forget. When the drug plans first came out in 2006 Humana had the cheapest plan. That plan has risen more percentage wise than almost any of the other plans. It started out at around $10 a month in 2006 and will be around 45 a month this year. Only a 450% increase.
Does any one remember Humana having enrollment boothes in most of the Walmarts in 2006 and Walmart kicking them out of because of the Humana Reps misrepresentation and misconduct? Seniors thought the were signing up in a stand alone drug plan and the Humana rep would sign them up in a Medicare Advantage because his commision for enrolling a senior in a Medicare Advantage Plan Was $400 instead of $50 for a Medicare Drug plan.
Humana will once againa use this low-ball drug plan premium to attract a lot of new customers and then hound them non-stop to convert their Stand-Alone drug coverage with Humana to Humana’s Medicare Advantage Plans. They did it before and will do it again! Sit back and watch.
Would like information on the Walmart-Humana RX drug plan and the medicine it covers.
John, I comment on many different Medicare Advantage plans and topics related to Medicare and do not have the information you seek. I believe that you should be able to find information on the 2011 Humana Walmart Preferred RX plan in a Walmart store. Many stores will have a Medicare Advantage kiosk staffed by an agent representing Humana.
Hi David, I certainly agree that the 2011 Humana Walmart-Preferred RX Plan is a price leader designed to attract a lot of interest that could be converted to an Advantage plan pitch. In my post I did question/warn about exploring the Humana drug formulary for this plan.
As for hounding new Humana Medicare Advantage plan members to convert their stand-alone Part D coverage, I hope it’s limited to mailings and stays within the CMS marketing guidelines. I wouldn’t want anyone on the receiving end of an over-zealous insurance agent chasing a commission.
Humana is not the only drug company to offer a cheap Part D plan to start, then rack up the prices the next year. Next year, along comes another cheaper plan which then increases (mightily) the next year. You have to play their game and examine your own needs each and every year. I have changed each year and will have to change again this year, I expect.
It’s what happens when you turn this over to the private sector. The government should have been the one and only provider of Part D coverage.
Alma, I agree that you should consider your needs on an annual basis when deciding on a Medicare Part D plan. I don’t agree when you say that “It’s what happens when you turn this over to the private sector. The government should have been the one and only provider of Part D coverage.”
If the government were to be the only provider of Part D coverage, competition would be eliminated and choice would be taken out of the equation. If the situation was different and the government was the only provider of Part D and your needs changed or they increased the premium (have taxes ever gone up?), where would you turn? Maybe it would create a market for insurance companies to offer Part D supplemental insurance!
Regarding the Humana Walmart drug card for 2011 my question is: If you need a tier one or tier two drug and get it through Walmart (or as before through Right Source) is it true that there is no deductable or co-pay? I know there is a $310 deductable once you get into tier 3 or go outside their approved drug providers. Their new plan seems to say that, but I need it in plain English.
In Las Vegas, the Humana Part D plan we chose went from under $7 to over $40 in 3 years—I think at one time I calculated a 540% increase. I was never able to get an answer from Humana, even though I worked my way up to the corporate CFO’s office. We now have an Aetna/Costco plan for just over $30, and it is going up to over $60 for 2011. So, we’re looking again. Sounds as though it is best to wait until after the election, however, as 2011 pricing information is difficult to get.
Blaire, It’s good you are being proactive to get the best plan you can each year. Many people just take the increases as a given. The Annual Enrollment Period is the time to do your homework and compare 2011 Part D plans. Most all information being published at this point is for 2011 Medicare Part D plans. I would start looking now. The elections will have no bearing on Medicare Advantage or Medicare Part D plans that are available for 2011. What happens in the future is anyone’s guess.
Lois, Their Humana Walmart-Preferred RX plan literature indicates that you will pay a $310 annual deductible for all tiers. The benefit is optimized when you receive your drugs from Walmart / Sam’s Club / Neighborhood Market pharmacies. If you use the RightSourceRx mail order benefit, you will not pay a co-pay for Tier 1 or Tier 2. You will want to stay away from non-preferred retail pharmacies with this plan, as the benefits are not nearly as good.
I would recommend that anyone who is considering this plan, request a formulary to ensure that you drugs are included. Also, decide if you are willing to pay extra for having the freedom of choice to frequent other pharmacies.
I am new to this game, having to enroll first time this year for a January start date. I currently take NO medicines. Do you think the Humana Walmart plan is general enough for me at this time? The price is certainly right.
Can the copays, formularies, etc. and other info be found at all Walmart or Neighborhood markets or Sam’s? Thanks.
Good question Michael. The formulary should not be a huge issue with you unless you can predict what medications you may require in 2011. The price for the Humana Walmart-Preferred RX plan is presented as the lowest for a 2011 Part D plan. So, if you made the assumption that you would not require medication in 2011, knowing that you can re-enroll or choose another plan next year for 2012 if your situation changes, it may be a good choice.
But, if on the other hand, you do require some drugs in 2011, you will be responsible for the $310 annual deductible before you receive any benefit. That would amortize to $40.63 per month and now you have an out-of-pocket of $40.63 per month. About average for a 2011 Part D premium, but use a non-preferred pharmacy and pay higher than average for your co-pays and you still need to explore the formulary. So you could argue either way. If $40 per month is going to be a hardship, you probably would qualify for low income assistance (LIS) and would receive a subsidy.
As for information being readily available at the stores; you will find a flyer but typically not the formulary, unless the store has a Humana kiosk staffed by a licensed agent. You may need to request the 2011 Humana Walmart-Preferred RX formulary from the company or a local agent.
I cannot locate an actual dough nut hole calculator for 2011. In order to decide what pharmacy to use, we really need this information. I called our local Walmart to get a price on a medication retail price was $84. Publix was around $115 and Walgreen’s which use says that my insurance saved me $195. I though co pays were all the same with any insurance company. However, was in Publix and purchased a mild pain killer for dental work and it cost me $3.10. Had I taken this to Walgreen’s, it would have been $7.00 because they say that is my co pay.
Can any give me any input to this information.
I will most likely reach the doughnut hole in May or June and my husband most likely in June or July. If my thinking is correct, in some cases I might be better off just to pay the full price of the medication without putting in through the insurance carrier.
Thanks for any advice.
Barbara, The co-pays on a Medicare Part D plan are specific to the plan, not the pharmacy. The pharmacies you have spoken with may be misunderstanding what information you are seeking. Part D co-pays will be the same for a particular plan at all in-network pharmacies. The problem with many of the calculators that estimate when you will reach the Part D coverage gap, is they don’t have specific information for what each insurance company pays for the covered medications. Insurance companies don’t pay retail because of the volume of medications that they purchase. Out -of-pocket costs related to the Part D coverage gap include what the insurance company pays and what you pay in fixed co-pays.
Also, you could speak with your doctor to see if any medications you are currently taking are available in a generic that you may not have been aware of. Often when you are proactive and communicate your concerns about costs with your doctor, they will recommend another similar less expensive medication that may be suitable. It’s also a good idea to utilize the mail order pharmacy benefit for any maintenance medications you or your husband may be taking.
Another community based service that is often available to help you with these types of concerns is The Area Council on Aging or similar group in your area. Check your local directory listing or contact your local Social Security office and ask about non-profit groups that council seniors on Medicare related issues. I hope this steers you on the right path.
As you state, the formulary is critical to selecting a Part D plan. Why isn’t your 2011 formulary available on line ?
I don’t want to have to go into a Walmart to get the information I need.
Dave, I blog about many different Medicare Advantage plans and am unable to post the hundreds of formularies available from all the insurance companies. I did locate the Humana Walmart-Preferred RX Plan formulary on Humana’s website for you. I hope this helps.
How do you go about getting a list of medications that this plan covers. I really would like to know if this plan covers Plavix 75mg. and Primidone 50mg.? I would like to know as soon as possible. Thank you
Luara, Here is a link to the 2011 formulary for Humana Walmart-Preferred RX Plan. I hope this helps.
If I join the Humana Walmart drug plan will I still be able to use my CVS pharmacy (it is located in Newtown, CT)?
Marilyn, The Humana Walmart-Preferred RX Plan will allow you to use a wide range of Pharmacies, but the savings in co-pays will be if you use preferred pharmacies. Walmart, Sams Club and Neighborhood Market pharmacies are considered the preferred pharmacies. For example; a co-pay for a preferred generic drug at a preferred pharmacy is $2, but at a non-preferred pharmacy it will be $10. You will lose all of the savings of a low monthly premium if you do not use the preferred pharmacies. So, using CVS will cost you a lot more in co-pays.
I had Humana once before for 2 years and it was lousy,they used to cover the walmart brand relion insulin,I called and they said they didnt know if relion insulin was going to be covered,the relion brand is half the price of the novolin brand,they have limits on amount of pills a doctor prescribes per month,it gets tricky with this plan,aarp seem to be a better match,but relion ibsulin is a non prefered drug even tho it is half the price of the prefered brand.
Rick, It could be argued that all Part D plans are tricky. It’s hard to make a blanket judgment on any company’s Part D plans when they are subject to change on an annual basis. Judging a plan is also very subjective, as every ones needs are different. The Humana Walmart-Preferred RX Plan may not be a good choice for a lot of people, but to say Humana plans are lousy may be an over generalization. It certainly pays to do your homework and compare 2011 Part D plans to find what will work best for your individual situation.
I’m currently insured with a Medicare Part D Plan,which when
I signed up was only $42.50 every month. Now I’ve been in-
formed it is going to cost me $59.30 a month for the same
type of coverage. How can you convince me that this Humana
Walmart-Preferred RX Plan may be the better choice for me?
Could you send me some information on this plan?
Carl s Rose
Carl, I can’t convince you that Humana Walmart-Preferred RX Plan is a better choice for you. You must weigh your own set of circumstances. I think that the article is fairly balanced and points out some of the positive features of the plan while encouraging you to research the plan further to determine if there is a correlation between cost and value. I comment on many Part D and Medicare Advantage plans and as such, do not have information on all the plans available. Visit http://www.humana.com and choose the link for Medicare plans. Thanks for your comment. I’m sorry your current plan increased so much.
I am an RN in ICU for 35 years. I just went over the entire formulary.
It seems the majority of drugs here are tier 3 and 4. The most administered antihypertensives are not even listed. I also take 4 BP medications. 3 which are not on here and they are not unusual medications.
I have looked at other formularies and they are listed on those, but not here.
So it seems that this list is extremely limited for the most used drugs for heart disease / hypertension .
No wonder it’s so cheap. You’d have to jump through 10 hoops to try and get any type coverage and then it would be limited.
How do I find out if my prescription drugs are on the formulary and will there be a doughnut hole with this plan?
Roxann, Here is the Humana Walmart-Prederred RX Plan Formulary for 2011. The Medicare Part D program is regulated by the Centers For Medicare and Medicaid Services (CMS). All Part D plans have a doughnut hole. When the Part D coverage gap is met and how much you will have to spend before you reach the catastrophic level of coverage, is standard with all Part D plans. Health care reform afforded you some help in the coverage gap for 2011. While in the gap, you will pay about 50% for brand-name drugs and 93% for generic drugs. What may vary from plan to plan is whether or not there is any additional coverage while in the doughnut hole.
Karen, Thanks for your for your professional insights as it relates to this 2011 Humana Part D plan. You are absolutely right, the formulary is the main determinant of monthly premium for Part D plans. This doesn’t sound like it would be a good choice for you. The key that people should take away from your comment is that you did your homework, researched the plan formulary and then made an informed decision. Too many people will purchase this plan based on price alone and many may find out that they made a mistake.
That said, no one should construe that I am bashing Humana and 2011 Humana Part D drug plans. If you visit Humana’s website, you will see that they offer four plans in total for 2011: 2011 Humana Walmart-Preferred RX PDP, 2011 Humana Standard PDP, 2011 Humana Enhanced PDP, and 2011 Humana Complete PDP. When evaluating Part D for 2011, we should recognize that it is not one size fits all. Nor is Humana likely to be the only company offering plans in your area. Choice is good. The Humana Walmart Part D plan is another option and for many people whose drugs are included in the formulary, saving some money may be just the ticket.
My current Medicare Drug plan more than doubled its monthly premiums for 2011. So I’m considering switching to Humana Walmart-Preferred Rx Plan because I’m currently taking an inexpensive drug (Levothroxine) that cost only $6.22 for a month’s supply. I would like to continue going to my local Rite Aid pharmacy. You mentioned the Humana-Walmart plan would have a $10 copay at a non-preferred pharmacy. I don’t quite understand copays. Does it mean that I would have to pay $10 instead of $6.22?
Clive, Actually it’s a little more complicated than that. The Humana Walmart-Preferred RX Plan requires you pay an annual deductible of $310 for 2011. The $6.22 that you currently pay for your Levothroxine is a copay. The actual cost to your current Part D plan could be greater than that. What ever the cost, you will be required to pay that amount until you have reached the $310 deductible. Then if you are going to your local Rite Aid pharmacy, it would be considered a non-preferred pharmacy and you would be required to pay $10 for a 30 day supply.
A general point about 2011 Part D plans with a deductible is that you must amortize the deductible over 12 months. Most people on Medicare will have at least $310 in drug costs. So to get the true monthly cost of the Humana Walmart RX plan for example, divide $310 by 12, which equals $25.83 and add that to the $14.80 premium for a total cost of $40.63 per month. Compare these 2011 Part d plans closely to make sure you’re actually getting a good value.
David, Thanks for your prompt reply. I should have given you more info. With my current insurance, First Health Part D, I have not reached my deductible of $175 and will not because my only drug expense is $6.22 per month. On each statement I receive from First Health, it states: Amount You Paid = $6.22, Amount We Paid = $0.00. On the Internet, I checked the price of my 50 MCG Levothyroxine without insurance and it was $6.08 per month – about the same as I’m currently paying, so from that it appears I’m paying the full price. But then I became confused when I went to my local Rite Aid pharmacy and they said, if I did not have any insurance, my cost for the Levothyroxine would be a little over $13 per month. I also called Humana Walmart and asked them how much I would have to pay with their plan if I went to my local Rite Aid (a non-preferred pharmacy). The agent looked it up and told me $5.66 for a month’s supply. I asked him about the copay. He said that kicks in when you’ve reached the $310 deductible. He also said that, if I reach the deductible, my drug would then increase from $5.66 per month to $10 per month.
Because my current drug costs are currently low, I plan to sign up with Humana Walmart because of their low premium.
Clive, It sure sounds as though you have done some comprehensive research on your 2011 Part D options. It sounds like your logic is sound on choosing the Humana Walmart-Preferred RX Plan for 2011. I wasn’t aware that the medication you referenced was so inexpensive. If you medications change, you’ll want to go through the process again next year. The fun never ends!
Does Humana pay for home delivery? If so how does it work? My parents do not drive anymore and it is hard to always find a ride.
Peggy, Humana Part D is available as a mail-order option called RightSourceRx. Co-pays for drugs on Humana’s Part D plans will vary by plan. If you are interested in the Humana Walmart-Preferred RX Plan, you can receive both Tier 1 and Tier 2 drugs with a $0 co-pay. Tier 3 is 20% coinsurance and Tier 4 is 35% coinsurance.
David..The Tier 4 35% is why i chose another drug plan. I have no idea how much 35% would be but with the plan i chose i know the cost of all my meds because they don’t (hide) the cost under a %.
John, I know how you feel. Most 2011 Part D plans now have a coinsurance amount for Tier 4 because the cost of high end drugs can vary so widely. What’s more frustrating is Part D plans with coinsurance amounts for Tiers 2 and 3 as well. I’ve seen some plans that list the cost sharing of a tier as a copay, but with a range, like $12-$22. It’s difficult to evaluate what your potential out-of-pocket may be with this type of cost sharing.
I enrolled with Humana Part D in 2009. A few months before the year was up my monthly premium went from $23 a month to $43 a month. I was told there was nothing I could do about it and that I had to pay that amount until year’s end. If I refused to pay they would turn it into a collection agency. How do I know that the same thing won’t happen again? A bait and switch before the end of the year?
Carol, I’m not sure how that could have happened. Insurance companies enter into a contract with CMS to provide Part D plan on an annual basis. The premium should not change during the calendar year. If a premium for a particular plan is going to increase for the following year you will be notified typically in October. If this is the case you can choose another plan.
Sometimes if you are receiving a subsidy and your income or the parameters set by the State for income change you could see a change in premium due to you having a lower subsidy. I’m not sure this is the case, but could be one possibility. As far as the collection agency comment, sounds like something a dishonest agent might say. If you don’t pay your premium, you are generally dis-enrolled from the plan. If you have a bad feeling about Humana you could also look at some other 2011 Part D plans.
Thank you David…I wish now that I would have investigated further. But I just went ahead and paid them.
How is the premium billed to you concerning the deductable? Is the bill going to say $40.63 every month for the nest of the year? Also how do I find out what the walmart pharmacy price is for my medication.
Glenda, The monthly premium for the 2011 Humana Walmart-Preferred RX Plan is $14.80 per month. This can be set up to come out of your Social Security benefit, drafted from a personal bank account or you can receive a monthly bill in the mail. The deductible is separate from the monthly premium. To meet the Humana Walmart Part D plan deductible, you will pay the first $310 costs for your prescriptions. In other words, copay or coinsurance benefits will not begin until you have spent $310 out-of-pocket.
If you are asking what your cost will be for medication costs you will need to pay while you are satisfying the deductible, you could ask a pharmacist at Walmart. Otherwise costs after the deductible are met will depend on the drug tier and whether or not you use the Humana Right Source mail-order program.
I only take two generic, low cost drugs now. What if the unthinkable happens and I need really expensive medications before the year is up. What happens?
Sue, Assuming your theorizing that you are enrolled in the Humana Walmart-Preferred RX Plan and this happened, you would be subject to the plan’s provisions and potentially run the risk of paying a higher cost or not having your medications provided in the formulary. This is one of the questions that gets asked about all types of insurance. You need to assess your own health and finances and purchase as much protection that is prudent for your budget.
What will the price be when using preferred pharmacy for tier 1 med. before meeting the yearly deductible (310.00)?
Will it be $2.00 or does the deductible must be paid first in order to get the $2.00 price?
What exactly constitutes the “deductible”? Do prescription drugs not covered on a plan’s formulary count toward the deductible amount that must be met before plan benefits begin? In other words, do all prescription drugs count towards the deductible. I ask this because I take prescription drugs that are compounded and not covered under any plan. They are expensive but my pharmacist told me that they can help me meet my deductible. Is this true?
Pamela, If your drug benefit is provided by a Part D plan your pharmacist is misinformed. A deductible is your out-of-pocket expense for drugs in your plan’s formulary that you are required to pay before you are afforded the benefit of copayments or coinsurance.
Thelma, The deductible must be met before you are afforded the copayment amount. Different tier 1 drugs will have different costs. The Humana Walmart Part D plan requires a $310 deductible for all tiers.
My husband and I just signed up for Humana Walmart Part D to begin Jan 1. 2011, We are changing First Health the part D coverage we had from July to Dec. 31 2010. My husband became 70 years old and retired in July 2010. We began part B and part D in July 2010, until he retired we had been insured by the company he worked for. We decided on First Health Part D cost of $18.70 each per month($175.00 deductible each).
Now 6 months after beginning with First Health we have been informed by First Health the monthly cost for 2011 will be going up to $34.10 each for 2011 ($150.00 deductible each. At this time my husband and I take mostly generic drugs and have all our prescriptions filled at Walmart unless we happen to need a new medicine when we are away from home on a trip and can not find a Walmart store near to have it filled in.
The while system seems so unfair to the regular folks and very confusing. SHIRLEY
Shirley, I agree it can be confusing. If you recently submitted an application for the Humana Walmart-Preferred RX Plan, that will be the plan that is effective and in place on January 1. First Health Part D sent you a letter required by law to let you know what your current 2010 plan would look like in 2011. The letter was already in the pipeline or they hadn’t been notified by CMS (Centers for Medicare and Medicaid Services) that you intended to switch. If someone has Part D coverage and does not submit a new application for the following year, they will automatically be rolled-over into the following years plan with their current company.
It sounds like, given your requirement for mostly generic drugs, that you and your husband will save some money by switching. The First Health Part D annual premium on the plan mentioned will be $409.20 plus the deductible equals $584.20 each. The annual premium plus deductible for the 2011 Humana Walmart Part D Plan will be $530.80 each. A total annual savings on premiums and deductibles of $106.80 combined. If you can use the Humana Right Source RX plan you can save even more, as tier 1 and 2 drugs are $0 copay. As far as the system being unfair, prior to 2006 most people on Medicare had no drug coverage. So having a Medicare drug subsidy beyond what Medicare was ever intended to cover doesn’t sound too bad!
And note that while the Humana Wal-Mart Medicare “D” plan has a low monthly premium, they have placed generic drugs on level 3 that other plans place on level 1.
More bate and switch??
Charles, Good point. If you check out some of my posts on this site I repeatedly warn people to check which tiers drugs are placed in and compare that to other plans. There are a lot of moving parts with 2011 Medicare Part D Plans.
I’ve been through several dozen sites just trying to find the cost of a 90 day supply of 20mg Lipitor. I’m a new member of Humana Walmart’s PDP plan and trying to find info has been a major pain! I want to the info so I can review my options.
Robert, here’s a link to a printable drug list on Humana’s website. This page lists all Humana Part D plans and plan formularies can vary State to State. Scroll down to find the plan for your location and choose comprehensive listing. The drugs are listed alphabetically with the tier listed. The price will vary depending on whether or not you are using a Humana Walmart preferred pharmacy.
This evening, I received a call from a man with a foreign name and thick accent asking me to verify information on my Walmart-Preferred Rx plan. Please understand, I don’t do this sort of devulging personal information over the phone when seniors are being targeted for identity theft and many other scams. If Humana is interested in my verifying information for the enrollment, please contact me by regular mail. I will be happy to verify any information you may need. I am very weary because of late con men gather information from different sources, including doctor’s offices, they confirm it with the person herself- to check that all information gels. Then they perform their scam.
Juanita, I certainly understand how you feel. The phone call was not generated by any activity on this site, as this is a blog that is neither owned or operated by any insurance company including Humana. Medicare Plan Review contains information on many Medicare plans and news items related to Medicare.
The phone call was more than likely the Outbound Education Verification phone call that Medicare requires all Part D and Medicare Advantage Plan sponsors to make. The intent is to make sure you are not being subject to a scam and to verify that you are fully aware of what type of plan you enrolled in. It seems more than anything a way to keep the agent that enrolled you honest. Most companies hire outside contractors to make the call and they are only to verify your name and birth date. Both of which would be easily attainable without going through the hassle of a phone call.
The person that enrolled you should have informed you that this call was going to take place and what information would be required. It sounds as though insurance companies should do a better job of letting you know what to expect. I’m sorry you had this experience.
I am trying to find a way to DISENROLL from the Walmart Humana Medicare Drug plan
Jean, Unless you are entitled to a Special Enrollment Period or can prove misrepresentation or misconduct by Humana Medicare you are not going to be able to dis-enroll and enroll in another Part D plan for 2011. The Annual Dis-enrollment Period which began January 1 and ends February 14 is only for those people who wish to dis-enroll from a Medicare Advantage Plan and return to original Medicare.
I’m not recommending that you try this, but you could cease to pay for the plan. You will either be without Part D coverage for the remainder of 2011 or Humana Walmart Preferred Rx will continue to provide you coverage and try to collect the premiums. Speak with a local agent to determine if you may be in any way entitled to a Special Enrollment Period. For instance; if you receive low income assistance (LIS) for Part D or are receiving Medicaid through your State.
Medicare is filing a grievance for me against Humana (Walmart plan) because they suggested the plan and signed me up. My BP med is not covered but the generic is according to their website. When I had the first RX filled I was charged the retain amount. I have talked to 9 agents at Humans with almost as many answers. The recurring answer is that Humana only tells the drugstore (CVS) what the copay is and nothing else. They insist that the drugstore charges what they want based on the cost to manufacture the drug!It seems that I must pay the full $310 up front before they cover anything and they don’t seem to know what I am talking about when I mention negotiated prices. One agent told me that Losartan was not covered although I was looking at their webpage. I just had a call from an agent who was telling me the same story and suggested that I call the “pharmaucital company. After she gave me a # to call I asked what the name of the company was and she said FDA!. I have passed this along to a Medicare agent who is as non-plussed as I am. What can you tell me?
Anna Belle, It sounds like Humana Medicare agents need to get their story straight. I have a copy of the Humana Walmart Preferred RX Plan brochure in front of me. The $310 deductible is for all tiers and must be paid before you are afforded the benefits of copays or coinsurance. I don’t understand the fact that you are paying retail prior to fulfilling the deductible. Humana’s other Part D plans will afford you re-pricing and so should the Humana Walmart Part D plan. The fact that you have been told so many different “truths” may bode well for your grievance being approved.
David thanks for your reply (please forgive the typos. I am just getting use to my new laptop. Am I wrong that there is a negotiated price that is less than retail in effect until the deductible is met? I was charged $81.59 for a generic drug that Humana’s website lists as around $15-$17. I tried to get a price from Walmart but they refused to quote me unless I brought in the RX.I am beginning to think that I am being punished for using CVS instead of Walmart. I was willing to pay a little more for the convenience and established relationship, but this is ridiculous!
Anna Belle, Common sense would dictate that to be the case. Let me know how things turn out.
DO NOT and I mean DO NOT take their word that the prescriptions you need are covered under this plan. When I was checking on changing prescription drug coverage I was assured that all the medications my husband and I were taking were covered. I switched from Blue Cross and sent in my prescriptions to be filled. They denied coverage for my pain medication that I was assured was covered and then denied my Dr.s statement that I NEEDED this medication to control pain. To have this filled will cost me $212.00 per month! Again, don’t believe ANYTHING they tell you to get you to switch unless you have them on tape.
Joanne, Before you enroll in any Part D plan make sure that you have a copy of the plan’s Part D formulary. Having someone on tape is neither practical or legal in most states.
Sir. I am male 65 years old,have really newer been ill, hardly ever needed to use any prescription drugs and dont forsee any problems. I am endrolled on Medicare part A and B but dont have part D, drug coverage, how I would know witch plan to join when I dont know witch illnesses I migth have in future, thank you, Olavi
Olavi, Given your situation I wouldn’t over think your choice of a Part D plan. Generally, Part D plans with a standard formulary don’t have a huge amount of variance as to drugs covered. The difference is in monthly premium, copay amounts or whether or not you will have a deductible. At this point I wouldn’t enroll in a Part D plan with an expanded formulary unless you don’t mind paying significantly more to have peace of mind for what might happen in the future.
Also remember that you can change your Part D plan on an annual basis during the Annual Enrollment Period (AEP). The AEP for 2012 plans will begin October 15 and end December 7. Here is a related article on Part D enrollment.
I feel these people’s pain as it is difficult to decide on and the fact we have to have part D ( incase) . You don’t even want to mention to these people about if they first get medicare there will be a penalty if they don’t choose it lol!!! I have not slept as been doing so much homework myself on this issue of medicare and an advatage or supplement!! the F plan, very baffling! My problem with this whole thing is, if I am taking a medication for the last 19 years a generic only costing 15.00 at cvs. I rather pay cvs the 15.00 for my medication , which my doctor writes and they fill, and go to walmart for other meds if I need them in the future because according to all of the part D I have to have “their” permission to take my medication!! and the quantity,, so each year my doctor would have to write saying why I have hypertension and that is why I need the medication, it is crazy! I have taken it for 19 years! I will pay the madatory part D to Humana,, and just keep paying the 15.00 to cvs for my medication with out the yearly hassle of them (humana) saying, well whe have your doctors approval and decide!!! after 19 yr I dont think so. This is so messed up!! I truly feel sorry for the elderly, the system is a mess even with Medicare, they have to pic MA or a supplment and trust me!! That is not easy!! It is like picking mutual funds for a 401k plan!! at 60!! or 70 etc!!! OMG>>> I was hoping for universal health care!! and it would depend upon income, that makes the most sense!! oh well,,,, Your a trooper to help these kind people,,, feel badly for them!! Thanks David
Julie, Thanks for your comment. Your right Medicare Part D can be confusing. Also being denied Part D coverage for a drug does not mean you cannot pay for it out-of-pocket. I’d rather people enroll in a plan to avoid the penalty and to potentially save some big money especially if they require drugs in tier 2 and above than to go without.
Thank you for visiting my blog. I have been on Medi-Can’t for several years. Funny thing, when I was working I had better coverage than I do now NOT working with Blue Cross and Medi-can’t. If you are ever in need of some Boomer Humor, just revisit my blog. We are also raising our two grandchildren (who, by the way have better coverage than we do.)
For years I have only taken 3 generic prescriptions. For 2012 I will take the same 3 generics. I plan on enrolling in the Humana/Walmart Part D plan for $15.10/mo, but I will continue to buy my generics at any pharmacy that offers the low cost generics for $2 to $4 and I will not use my Part D plan (I only get it because it’s required to have a plan). This seems to offer me a low cost premium plan and I will not need to pay the $320 annual deduction as I won’t use the ‘plan’. In fact, Humana/Walmart will not even know I use prescriptions. Is this acceptable.
Robert, It’s acceptable. But if you used your Part D card you would more than likely pay the same and have that amount apply towards your deductible. If the unexpected need for a new medication should arise you would be that much more ahead of the game related to meeting your $320 deductible.
Pain meds are covered only on tier 3 percentage….
Other plans just a have five dollar copay… Only after I signed up did I find this out. They don’t say they are not covered… THAT would have been a red flag.
It makes the humana plan through the roof the wrong plan for me. I wish it was easier to determine this BEFORE signing up.
E, You can visit any plan’s website and review the formulary (list of covered drugs) prior to enrolling. Not doing so is like buying a car sight unseen without a test drive. You can visit medicare.gov and search for plans in your area. You even have the opportunity to enter your drugs and have your results filtered showing projected costs. A formulary includes information about tier placement so you can estimate costs. I know it’s a painful lesson to pay through the nose for drugs that would be cheaper under another plan and I bet you’ll get it right next year.
I just found out at the pharmacy that my Medicare Part D Plan was changed to Humana Walgreen.
I never got a notice in the mail and was shocked. Call they will send brochure and ID card.
How can I find out on the Internet the prices of the drugs I take. I was completely happy what with I had. They said I was transferred because of the small amount of money I received from SS. I was only paying l.l0 for my meds and the most expensive one is 3.30. I am so confused and don’t know where to go to. Can you help me, I just get recorded messages at their phone number. Thank you if you can help I am at my wit’s end.
Jeanniefrank, The plan is Humana Walmart-Preferred Rx plan, not Walgreens. Your copays were low because you were receiving extra help because of your income. If your income has not changed your copays will be the same with the new plan. There are approximately 60,000 in-network pharmacies, including all Walmart Pharmacies. If you receive extra help with your Part D, you are entitled to a Special Enrollment Period and can change plans if you like.
If you are considering Medicare Part D, and if you are an eligible veteran, you should not that the VA drug benefit program is considered a “Credible Coverage” per Medicare Part D (i.e. no penalty to change to a different coverage later). Also, the VA program has no monthly premium (save $18/month) and in Michigan, only an $8 copay. Many generics only cost $4/month at some discounters such as Sam’s Club & Target. Good stuff to consider for the aging vet.
do you have to be on medicare to have this benefit
Rosie, Humana Walmart-Preferred Rx is a Part D plan and you must have Medicare to qualify.
I am in a real quandry! I am 66-1/2 and since 8-1-13 have been on AARP UHC MA PPO Choice 2 plan ($0 premium, but increasing to $29/mon in 2015). My plan has a prescription benefit that includes my only prescription med (Armour Thyroid, since 1997) in its formulary. I do not buy my Armour Thyroid through the plan, though, as it is cheaper and FAR LESS HASSLE to buy out of pocket in quantities of 100 or 200 at a time, which I couldn’t do if I bought through the plan. I spend just under $100 PER YEAR on my thyroid meds.
I don’t foresee that I will need other drugs for a long time, if ever. I take supplements and for many years have consumed an extremely healthy, grain-free, gluten-free, low-glycemic paleo diet that works great for me. My functional medicine board-certified NP is very happy with my blood test results, tells me to keep up the good work, and wishes all her patients had my dietary habits.
For 2015, I am tempted to switch from MA to a high deductible F plan (or possibly an N plan) to avoid the network hassles. BUT if I switch to a Medigap policy, I’ll be forced to pay a Part D premium and will never come remotely close to meeting the $320 annual deductible. I will be subsidizing other people’s drug habits and forking over more $$ without getting any direct benefit from it. I know, I know, 10 or 15 years from now I may need a few more drugs and don’t want to incur the penalty.
Unfortunately, neither of my two employers offers a health plan or FSA — Medicare is it. As tempting as the HDF plan is, the Part D premium is so galling to me that I may just stay with my current MA plan to avoid paying the Part D premium and contain my drug costs — at least for next year.
OK, here’s the soapbox: I know most people think it’s impossible to live without being a good little pharmaceutical consumer, but Big Pharma/Big Ag are such a racket (don’t get me started!) — the current “health care” system (AKA disease management system) does not support real health, because it provides incentives for companies to keep people sick and unhealthy. And when there is no financial incentive to keep people healthy, it’s profits before people. Real health does not come from drugs and surgery — it comes from good health habits. Rant over.
I would LOVE the option of a Medigap policy without being forced into a Part D drug supplement, or would LOVE a MA policy that didn’t force me to be confined to a network. Sigh, there’s no good answer for people like me, is there, David.
Forgot to mention that, however galling the Part D scenario is, I’m guessing that what I need to look at is the total annual out-of-pocket each plan would have. Right now my AARP UHC MA PPO Choice 2 plan has $6700 in-network annual out-of-pocket maximum and $10,000 combined in-network/out-of network annual out-of-pocket maximum.
Gee whiz, that high deductible F annual maximum of $2,180 (for 2015) looks better already.
What can you tell me that will make me feel better about “throwing my money away” on a Part D premium in 2015 (and beyond)?
Barbara, I’m glad I could provide the soapbox! I’m in agreement… taking responsibility for your health is always better than relying on big pharma. If you really want to be a conscientious objector you could just go without Part D… it’s not mandatory. I’m not recommending that because human experience is filled with examples of people who were doing all the right things and living a healthy lifestyle only to be struck with a debilitating illness. You can enroll in Humana Walmart Preferred Rx (one example) for $15.70 per month. Think of it as…. insurance 🙂 My home is not currently on fire and I don’t think of paying homeowner premiums as subsidizing other people’s house burning habits!
Barbara, Not sure I can make you feel better… but I’ll try. It’s just a few dollars per month and if you don’t use the Part D you will not pay a deductible. I know… lame attempt. Just think of it as insurance. Pay as little as you can and hope you never need it.
Are only new enrollees entitled to the low premium rate? My premium was $14.80 the year I enrolled with a $310.00 deductible. In 2012 it went to $15.10/$310.00, In 2013, $18.50/$320.00 and 2014, $22.80/$320.00. Now for $2015 it is going up to $29.00/$320.00. Should we have re-enrolled each year to take advantage of the low premium?? Or would it not have made a difference. At present it is usually June or July before we meet our deductible. That don’t sound like a big premium, but when you multiply that times 2 (my husband) with total income of less than $2,000.00, it becomes a big deal. Can you give me some advise as to whether I should stay with what I have, or is there a better solution? I have Plan N as a supplement, as neither of us goes to the doctors more than 4-5 times a year, and this works for us, as far as premium/deductible is concerned.
Bonnie, The monthly premium for Humana Walmart Preferred Rx will be $15.70 in 2015. I’m not sure why your premium is going to be $29. Have they switched you to a different plan? The Deductible will be $320. The Part D Standard Benefit Model changes each year.
If they switched me to another plan they did not notify me. I guess I assumed it was an age thing and they did everyone the same. I plan to call today and hopefully SPEAK to someone. I am also wondering if they cover any part of the shingles vaccine, I am 67.
I am responding to my blog this morning. I contacted Humana about the difference in Humana-Walmart and Humana Preferred Rx plans. There is a difference in premiums, deductibles and formulary tiers. I enrolled in the ‘Walmart” Plan and will save nearly $500.00 on the year. And they do pay for the shingle shot. It was worth the phone call.
Bonnie, That’s great news! It pays to be on top of things.
You call the $3.10 premium increase “slight” That’s like saying the elephant man has slight swelling around the eyes! I consider a 24.6% increase “substantial”. 🙁
I am 68 years old and my health is excellent. I do not use any Rx medication. I reside in Wisconsin and I am enrolled in SeniorCare so that I meet the requirement to have part D to avoid the penalty. This plan costs $30.00 per year. Just throwing this out there as another option for those who don’t need Rx meds.
Regarding my last email, I would like to retract it but if I can’t I wish to at least apologize for my inaccurate assumptions. I have looked into this further and it was my mistake. Thank you.
Cathy, It has been deleted. Happy New Year!
wow, been paying for this plan for over 2 years. got ear infection and got ear drops which is not covered – cost $187 dollars for a tiny little bottle. call humana and there are forms for the dr and me to fill out.
this is not health care – feel like a criminal… on phone they are matter of fact rude..
am now looking to change carrier
D, You can call PlanPrescriber toll free at (888) 310-0376 and compare all plans that are available in your State. They can enroll you as well.
Can I get a link to the Humana Walmart Rx Plan (PDP) for my area of Escambia County, Alabama, Zip Code 36502? I need to determine what is available to offset drugs not covered.
Walmart Retail Prescription plan used to provide a list of approved medications and the tier for each. I cannot find one for 2018. Where can I get one for 2108?
Does your local Walmart have a Medicare kiosk staffed with an insurance agent? I would start their. If not call eHealth at 888 310-0376 they may be able to point you in the right direction.