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Why does Humana Walmart PDP @ 15.70 in GA have a $8.10 premium for 100% LIS.
Humana Walmart PDP and LIS Question.
- Thread starter kennethbroyles
- Start date
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It defies logic, I know. Try the Humana Preferred Rx plan. In Texas, that one is covered 100% by the LIS. Humana Walmart is cheaper for the person without LIS.
I've wondered myself why most PDP's have a zero premium with 100% Extra Help, but others don't.
I ran into this myself a few months back, when I enrolled a lady in Ft Oglethorpe in a Cigna-HealthSpring PDP. Out of three PDPs this year, two had premiums, and the Secure-Max was over $100/month, as I recall, with full LIS.
Here in Putnam Co TN the Humana-Walmart plan is $9.70/month with 100% LIS. There must be some sort of breakdown in the premium allocations that differentiate between "chargeable" and "nonchargeable" to LIS beneficiaries, I suppose.
THE LIS plan with Humana that cordinates best is the Humana preferred, not the Walmart.
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I just called Humana and verified this. The person that looked it up was surprised to find out that the Preferred Plan is free, while the Walmart plan is just discounted.
- Thread starter
- #6
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It's one of Humana's "Gotcha's!"
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The Walmart plan has "enhanced" benefits, and the Preferred plan is a basic plan, so the LIS is calculated differently.
The people I feel sorry for are those that had the Humana basic plan that changed to the "Preferred" plan when the Walmart plan was introduced.. They got higher premiums and less benefits. Most people did not understand what was happening.
The people I feel sorry for are those that had the Humana basic plan that changed to the "Preferred" plan when the Walmart plan was introduced.. They got higher premiums and less benefits. Most people did not understand what was happening.
And neither do you completely. The first PDP Humana launched was the Walmart Preferred PDP. It later dropped the Walmart name, but the CMS contract and plan benefit package# did not change. Then to add to the confusion Humana launched a new PDP simply called Walmart. No one was moved into anything; they simply didn't realize there was a name change (and a standard yearly change in benefits and premium) along with the launch of a new plan.
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Although they certainly had the relationship with Walmart with the kiosks, Humana didn't have a specifically branded Walmart plan until at least 2008. This is academic at this point, I suppose, but I know they did not have a "Walmart plan" in 2006 or 2007. In the beginning they offered Standard, Enhanced and Complete plans, with "Complete" only being complete the first year (2006) when it had no coverage gap for generics or brands. I felt sorry for the people who signed up for that plan only to have the premium go up in 2007 and have it only cover generics in the coverage gap.
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2015 LIS Qualifying Plans Tenn.
PDP-Facts: 2015 Medicare Part D Plan Facts and Figures by Region (State)
Plan Name Plan ID
AARP MedicareRx Saver Plus (PDP) S5921-357
Aetna Medicare Rx Saver (PDP) S5810-046
Cigna-HealthSpring Rx Secure (PDP) S5617-220
EnvisionRxPlus Silver (PDP) S7694-012
Express Scripts Medicare - Value (PDP) S5660-114
Humana Preferred Rx Plan (PDP) S5884-106
SilverScript Choice (PDP) S5601-024
SmartD Rx Saver (PDP) S0064-012
Symphonix Rite Aid Value Rx (PDP) S0522-016
United American - Select (PDP) S5755-083
WellCare Classic (PDP) S5967-149
WellCare Simple (PDP) S2505-001
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