PDP Games on Retail Pricing

[fun2drum]

Tier pricing is another issue.

I have a lady who is "married" to Walmart. LOVES her Humana WM plan in spite of them increasing premium from $20 this year to $30 next year. Lives on a tight budget but refuses to shop anywhere but WM.

She is on 13 or 14 drugs (up from 8 this year). All are generic. Most are psych related.

Humana WM plan has many of her generics at tier 3 and 4 and much higher retail cost than other carriers.

Tried to get her to move to Wellcare. Half the premium and lower copay but WM not on their preferred list.

Also encourage using GoodRx. Again, lower copay than her H WM plan.

Not budging.

Even the Wellcare plan used lower tiers for all or almost all of her drugs. Don't recall any being tier 3 or higher.

One thing I do know is that lots of people with the Humana WM plan are scared to death of letting it go. I wonder if that's part of why they increased the premium so much - to make moving to a MAPD more attractive to them. At least I've found that to be the case with some of them this AEP.

 

[mcd]

Has anybody ever figured out the logic behind the discrepancy? The site can easily suggest the wrong plan due to the estimated pricing being off if the plan charges a % of the cost.

Maybe we should not expect logic when we're discussing the govt.