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.