Humana PDP Changes 2020

[Devin01]

Humana Is back in the PDP business big time:

Lots of work for our PDP commissions this year!

1. Humana Walmart Value will now challenge Wellcare as the low-cost PDP plan
2. Humana Walmart Rx Plan will be mapped to Humana Premier Plan, Average monthly premium of $57.33

Have a look at the plan designs for next year

Humana Walmart Value Rx Plan (PDP)
• New in 2020! Low monthly premium of $13.20 (nationwide) and offers access to preferred cost sharing benefits at Walmart Retail Pharmacies and Humana Pharmacy
•Preferred cost sharing is available at over 5,200 Walmart, Walmart Neighborhood Markets, and Sam’s club (no membership required) pharmacies with in-store copays as low as $1 on a 30-day supply of Tier 1 medications

Humana Premier Rx Plan (PDP)
• Redesigned in 2020! Humana Walmart Rx Plan and Humana Enhanced Rx Plan members mapped to this plan
• Richest formulary and benefits
• Average monthly premium of $57.33 (varies by CMS region)
•Coverage enhancement: sildenafil (generic Viagra) is covered at a $4 co-pay (6 tablets per 30 days) at preferred retail pharmacies and $0 co-pay at Humana Pharmacy

Humana Basic Rx Plan (PDP)
• At all in-network standard retail pharmacies, members will experience a $0 co-pay on a 30-day supply of Tier 1 medications and a $1 co-pay on a 30-day supply of Tier 2 medications (after meeting deductible)
• Average monthly premium of $30.34 (varies by CMS region)
• Preferred cost sharing is available at Humana Pharmacy with $0 mail-order copay on a 90-day supply of Tier 1 and Tier 2 medications • Designed primarily for members who are eligible for low-income cost subsidy, also known as “extra help”
• Deductible of $435 • Offered in all 50 states

 

[Russ]

So the original Humana WalMart PDP is basically doubling in premium. Nice going Humana. I'll look at other companies.

 

[vic120]

So the original Humana WalMart PDP is basically doubling in premium. Nice going Humana. I'll look at other companies.

I didn't catch that the first time I read it

I am going to have to spend way too much time this AEP with Humana Walmart clients and Clients concerned about Welcare taking over Aetna

all with the newly designed Med.gov

Not looking forward to this year at all

 

[Devin01]

I didn't catch that the first time I read it

I am going to have to spend way too much time this AEP with Humana Walmart clients and Clients concerned about Welcare taking over Aetna

all with the newly designed Med.gov

Not looking forward to this year at all

this year is going to be brutal. Im hiring a temp worker to help us with part d for our agency.

 

[Russ]

I didn't catch that the first time I read it

I am going to have to spend way too much time this AEP with Humana Walmart clients and Clients concerned about Welcare taking over Aetna

all with the newly designed Med.gov

Not looking forward to this year at all

Ditto that. Already had someone call me that has Aetna PDP that apparently has already been notified it will be Wellcare in 2020 and his sister-in-law had Wellcare and didn't like it, so I had to assure him all will be okay.

Now watch him cancel his PDP on me this AEP.

 

[LostDollar]

I would think Kroger will be continuing to work with somebody to continue challenging WalMart for 2020.

 

[vic120]

I would think Kroger will be continuing to work with somebody to continue challenging WalMart for 2020.

You mean as far as network the network is the network if they are not in-network then they won't help with med fills

You mean as far as finding a plan think there are few others that do the same I am sure they find the plans they take though, for generic users not really an issue but some who have high drug cost you want to know all the options

 

[Russ]

So if I have 100 clients with Humana WalMart PDP, I can't talk to them about it till October 1st, plus all of the other work during AEP. Sure no big deal. Yeah, I'll wait

 

[MedSuppPro]

So if I have 100 clients with Humana WalMart PDP, I can't talk to them about it till October 1st, plus all of the other work during AEP. Sure no big deal. Yeah, I'll wait

Since Humana has an Agent of Record policy why can't we advise our PDP clients to call Humana October 1st. Have our PDP clients ask Humana to review and compare their current drug list. If it looks like the better plan then Humana would have to do a complete presentation and a document drop. The only problem is Humana will push their MA plans (No Agent of Record for PDP=>MA). Maybe the risk is worth the reward. I can start calling them when they get their ANOC -- as if I've got nothing better to do.

 

[vic120]

Since Humana has an Agent of Record policy why can't we advise our PDP clients to call Humana October 1st. Have our PDP clients ask Humana to review and compare their current drug list. If it looks like the better plan then Humana would have to do a complete presentation and a document drop. The only problem is Humana will push their MA plans (No Agent of Record for PDP=>MA). Maybe the risk is worth the reward. I can start calling them when they get their ANOC -- as if I've got nothing better to do.

If that is the case I don't know their agent of a record deal

However, My experience with them is I have lost clients when doing fast app and they call the technical support number doing app

I also had one that was with me on MA a year and the next year she wanted me to come to her home as she developed hearing issues, When I couldn't she called toll free on the back of card had a rep come to her house and I lost Agent of record on her

I also know someone who was at some meeting with Humana reps when he brought up that since so many are effected what if we have them a call would the agent retain agent of record I am told the response was just a laugh

Even still I am looking at so many I heart sank yesterday at the thought of reenrolling well over 100 clients ( Just checked again its only about 100) with just the Humana PDP I already have many that will call me over the Aetna buy out

I cant see a good ending to doing all those Humana apps But it pains me to let it go, I get a nice check every Jan

I am not too concerned about them being sold MA, These clients are well educated in Why they have supplement vrs MA However I don't feel confident I would retain agent of record

I think I will do that even if I lose agent of record, I just can't see it being worth it doing all those PDP reenrolls