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Humana Walmart Part D Plan – Review

Humana Prescription DrugsHumana Walmart Part D plan: reviewing costs vs benefits

Humana Medicare has teamed up with Walmart to offer the Humana Walmart-Preferred RX plan. The monthly premium for this plan is only $17.00 in most areas ($15 in IN, OH, KY). But the premium is not the only aspect to consider when comparing the Humana Walmart Part D plan to other plan alternatives. As with any purchase you must consider the costs and benefits to determine value.

Humana Walmart-Preferred RX Plan benefits

One unique aspect to this plan is the ability to save money at preferred pharmacies. Preferred pharmacies include; Walmart, Sam’s Club and Neighborhood Market Pharmacies. As you can see below, the savings are significant if you utilize preferred pharmacies, but some have questioned whether the cost-sharing structure for non-preferred pharmacies is in line with other Part D plans.

Humana Walmart PDP has no deductible for tier 1 and tier 2 drugs. Drugs in tiers 3-5 require a $400 annual deductible.

Here are the copays / coinsurance amounts for preferred pharmacies:

  • Tier 1  Preferred Generics $1 copay.
  • Tier 2 Generics $4 copay.
  • Tier 3 Non Preferred Generics and Preferred Brand 20% coinsurance.
  • Tier 4 Non Preferred Brand 35% coinsurance.
  • Tier 5 Specialty Drugs 25%

Compare these to the non-preferred copays / coinsurance amounts below:

  • Tier 1 $10 copay.
  • Tier 2 $15-$20 copay.
  • Tier 3 25% coinsurance.
  • Tier 4 44% – 50% coinsurance.
  • Tier 5 25% coinsurance.

Compare Part D plans including the plan Formularies to determine costs based on which tiers your current medications are listed in.

In order to maximize the savings afforded by this plan, you will have to sacrifice some freedom to choose from a larger and more diverse network of pharmacies. The Humana Walmart-Preferred RX Plan includes 4000 pharmacies in their network. In comparison, the AARP Medicare Part D plans include over 60,000 in-network pharmacies, including Walmart.

Here are the copays / coinsurance amounts for the mail-Order program giving you a 90 day supply:

  • Tier 1 $0 – $2 copay.
  • Tier 2 $8 copay.
  • Tier 3 15% – 20% coinsurance.
  • Tier 4 30% – 35% coinsurance.
  • Tier 5 90 Day Prescription not available – 30 day prescription for 25% coinsurance

 




Plan costs are not only monetary

When comparing the Humana Walmart Part D plan to your other options you should look at the actual costs in dollars and cents, but you also need to consider the network restrictions to maximize your savings. If you are happy with the preferred pharmacies, this is a non-issue. But if you don’t relish switching pharmacies or if the location of preferred pharmacies is not convenient, this too is a cost.

You also need to investigate the formulary. Medicare Part D formularies are the key to choosing the right plan.

Also when comparing Part D plans it’s important that you don’t overlook whether or not the plan has a deductible. 2017 Part D plans can include up to a $400 annual deductible.

Humana Walmart-Preferred RX Plan includes a $400 deductible tiers 3-5

There are many Part D plans with the same deductible. But there are also plans with a $0 deductible, although they will not typically have a $17.00 monthly premium. So this is where you need to break out the calculator to find the real monthly cost.

If you are not required to take medications, your real monthly cost is $17. But if you are like most people on Medicare, you probably are required to take some medication. If you were paying for your medicine out-of-pocket it’s more than likely safe to say that you would spend $400 over the course of the year.

If the later is the case divide $400 by 12 months. The deductible amortized over 12 months is $33.33. Now add that to the monthly premium and you get the true monthly cost (not including copays/coinsurance) of $50.33.

In summary, if you have investigated the plan’s formulary and determined that it includes your medications and you are happy using the preferred pharmacies, you may come out ahead on copays/coinsurance especially if you use the  mail-Order program.

There is not a single Part D plan that is best for everyone, after all Humana offers other Part D plans. When you consider the (more than likely) real monthly cost, the plan looks like it will cost you about what many of the competing plans will cost.

13 comments

  1. Humana Walmart Plan D review. Discussion of the impact of the annual deductible fails to explain that the deductible does not apply to Tier 1 and Tier 2 prescriptions. If you are only taking a few generics, you will not have to pay the deductible unless you have a new Tier 3 or 4 RX.

  2. Thanks for the clarification.

  3. when are they going to put 2015 drug list on line?

  4. Jim, All plan information is online now at medicare.gov.

  5. Dave,
    From the comments it seems that tier 1 generics do count toward the deductible.
    Am i mistaken? thank you

  6. Does the Humana-Walmart Part D plan include Silver Sneakers?

  7. Betty, Silver Sneakers is often included in Advantage Plans but I’m not sure it is included in Part D. Part D plans can vary from State to State. You could visit the Humana website to see benefits for your State.

  8. Pat, Some of these comments may refer to plans from years past. You should call the member services number on your card to get specif information.

  9. Don’t be fooled by the $1, $4 drug cost guidelines they claim to offer. I haven’t obtained a prescription yet that they have charged me less than $10 for( and all were generic drugs ).
    Also, if you plan on taking advantage of their $18.40 monthly plan, good luck with the service you will get at Your local Walmart.

  10. so, based on what ive read, the annual out of pocket is 365, plus the 18.50 a month, making the maximum expense roughy $500? This plan allows me to get trade name drugs on all my medications?

  11. Ron, All Part D Plans have their own formularies (list of covered drugs). You would need to consult the formulary to determine if all your drugs are covered.

  12. Ron is correct. Be careful. I’ve found that many of the drugs that are covered as tier 1(generic) or tier 2 ( non preferred generic) under other PDP plans are listed as brand name drugs under the Humana plan. This means you will pay a considerable amount more for those drugs and also the $360 deducible applies.

  13. Plan D customer

    Good source for basic cheap drugs (the ones that cost about $4 a month from walmart) were free when ordered at 90 day supply online. However, Tier 4 drug costs 13 times what I found it for from another reputable mail order pharmacy and 5 times more than my local Walmart would sell it to me without insurance. It is important not to give them a credit card to automatically bill Rx without checking price elsewhere. In general, I feel I HAVE to have a prescription plan since Congress wants to help out the rich insurance industry, and so I buy this plan though at the end of the year, I pay far more than I benefit just to keep from being penalized sometime in the future for not going along with our Congressional Plan to help out the rich insurance industry. So sad. Our country is falling further and further behind other countries in health care options.

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