Humana First Look?

The UHC Saver plan is non-commissionable in 2025 😑.
I will be pushing the Humana Value plan almost exclusively except for those who need a drug covered that’s not on the Value plan formulary, and in that case they likely will be moved to Anthem or UHC.
The desirability of those options, based just on premium which is all I can see as a non-agent, may vary state to state.

According to my Medicare and You book, in KS for 2025, the Humana Value plan will be $34 and the UHC plan will be $97.
 
The UHC Saver plan is non-commissionable in 2025 😑.
I will be pushing the Humana Value plan almost exclusively except for those who need a drug covered that’s not on the Value plan formulary, and in that case they likely will be moved to Anthem or UHC.
I just confirmed with my local broker manager with UHC that both of their PDPs will be commissionable for 2025. They also mentioned the same thing at their rollout last week
 
I just confirmed with my local broker manager with UHC that both of their PDPs will be commissionable for 2025. They also mentioned the same thing at their rollout last week
I just found out that the plan that I th
I just confirmed with my local broker manager with UHC that both of their PDPs will be commissionable for 2025. They also mentioned the same thing at their rollout last week
Humana just introduced a $25/mo plan that many agents automatically assume is an “LIS” plan much like UHC’s and Devoted’s. Those 2 plans allow a “buy-in” if not LIS-qualified. Anyone willing to pay additional premium gets additional benefits and better benefits package.
Humana (being Humana) is not like that according to to the agent manager that I asked. It will be $25 whether LIS or not, since it is subsidized by the medical side, not the Rx side subject to LIS discount. Bummer.
 
Potentially even better will be UHC Saver PDP... $5 premium and 16% T3!

The desirability of those options, based just on premium which is all I can see as a non-agent, may vary state to state.

According to my Medicare and You book, in KS for 2025, the Humana Value plan will be $34 and the UHC plan will be $97.

How to explain these differences? In California, UHC Saver is even worse than in KS - it's $124.80!

And Humana Value is $94! (Not $5 and not $34.)

Is it that there is more penetration of MAPD in California, leaving a less healthy pool in OM+PDP?

Is there a stronger pharmacy pushback here resulting in higher prices?

Perhaps a plan's formularies can vary across the country, so maybe they have a stronger formulary in California than elsewhere?

Or is it just a matter of competition? Getting away with whatever they can? (But they will have to share back with Medicare some portion of their profits if they overcharge. The Medicare demonstration project is reducing their liability for losses, but I don't think the project is changing the formula for sharing profits with Medicare.)
 
How to explain these differences? In California, UHC Saver is even worse than in KS - it's $124.80!

And Humana Value is $94! (Not $5 and not $34.)

Is it that there is more penetration of MAPD in California, leaving a less healthy pool in OM+PDP?

Is there a stronger pharmacy pushback here resulting in higher prices?

Perhaps a plan's formularies can vary across the country, so maybe they have a stronger formulary in California than elsewhere?

Or is it just a matter of competition? Getting away with whatever they can? (But they will have to share back with Medicare some portion of their profits if they overcharge. The Medicare demonstration project is reducing their liability for losses, but I don't think the project is changing the formula for sharing profits with Medicare.)
When they got rid of catastrophic coverage, it dramatically increased plan liability, but was offset by an increase in the Direct Subsidy. However, the Direct Subsidy is the same number nationwide, whereas individual states have a lot of variability in their drug liability, which used to get smoothed out by the catastrophic coverage. Some saw much bigger increases in liability than the Direct Subsidy.

The reasons for the higher liability in some states are many, you can't bring it down to one cause. But it is what it is.
 
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