Medicare D My Experience with Humana Medicare

Before joining Medicare D, I had to sit down and make a list of all of my husband’s prescriptions.  I can tell you at that time, he was on 10 or maybe 11 different drugs.  I calculated an estimated retail cost of about $8,000 – $10,000 per year and that was dependent upon discontinuing a drug.

That year, which was 2006, and the first year for Medicare D, Humana Medicare actually offered a plan for about $60 a month and covered you through the “do nut hole” (coverage gap) for all prescriptions, – both brand and generic. And the co-pays were $25.00 per brand name drug and $5.00 for generic drugs.

Wow – this was a great plan from Humana Medicare.  We didn’t have to worry about the “do nut hole” or any additional out-of-pocket costs considering the annual expense for his drugs.

Important – Check Your Plans Every Year For Changes

Every year a Medicare beneficiary has the option to change plans, opt out of the Advantage plans and go back to original Medicare.  Something I would encourage everyone to do is to make sure if you are in an Advantage Plan or participate in Part D, review the changes that your plan is making.

Here’s What Happened to Us

Humana Medicare, for 2007, revised the Medicare D plan we were in for 2006 and increased the rates to I believe $80 per month and dropped payment through the “do-nut hole” for brand name drugs.  They would however pay for generics through the “do nut” hole.  That just didn’t make too much financial sense.  Guess what, if I hadn’t reviewed the changes we would be paying a premium of $80 per month.

Humana Medicare offered 2 other plans and we found one for $23.00 a month, with a $25.00 co-pay and it included the annual deductible.  It worked, for 2007 and 2008.

But guess what, after having a fairly good Medicare D plan for 2 years, Humana Medicare again changed the pricing for 2009.  They went from $23 monthly premium to $42 and the co-pays went from $25 to $40.  That’s a huge increase.  So, back I go to http://medicare.gov to look for a new plan.  We selected AdvantraRX for 2009.

The Coverage Gap

In order to stay out of the coverage gap, we shop at two different pharmacies, one for brand name and one for generic.  We also purchase a few prescriptions out of Canada at http://canpharm.com.  And I review our current plan every year starting in October.

If you haven’t been checking your plans, start now, it’s an important step in controlling some of your healthcare services and costs.

—Mary Jane Stern