Wow, Just got the renewal notice on Plan D

[mf15]

As far as I can find for MA, drugs are excluded from MOOP. So you will
not have a cap on drug costs.

It also looks like if you can find a MA plan without drug coverage the you could also
get a part D plan. There are not that many without drug coverage.
Real interesting if you get a MA plan with drug coverage, you have to hunt
for the info that drugs are excluded from MOOP. They say it is part D coverage
but it really is not. Pretty sneaky. Also on the plan finder for MA without drug coverage
it just says you will have to pay for all the drugs, does not mention to go get a part D plan.

Heck I have some friends with conditions, they are on like 12 drugs a day.

I can see that some older folks that may not be up to snuff in their mental capacity
really causing themselves problems by picking the wrong plans. The gov't and insurance
companies are not making it easy.

oldmike

 

[MBSC]

It also looks like if you can find a MA plan without drug coverage the you could also get a part D plan.

Enrolling in a stand-alone PDP is an easy way to leave Advantage and return to original Medicare (supplements are a separate issue). It doesn't matter if the MA plan had a PDP or not.

Drug coverage in Medicare Advantage Plans

You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:

* You’re in a Medicare Advantage HMO or PPO.
* You join a separate Medicare Prescription Drug Plan.

Source: https://www.medicare.gov/sign-up-ch...ge-plans/how-do-medicare-advantage-plans-work

However, there is a special type of Advantage plan that does not fall into the HMO/PPO category called Medicare Medical Savings Accounts (MSA). MSA's never include a PDP so they can enroll in a stand-alone PDP.

The MA HMO/PPO plans without PDP coverage are meant for those who already have PDP coverage from another source (such as Veteran's benefits) and people who do not believe in taking these drugs.

 

[Chuckanut]

Enrolling in a stand-alone PDP is an easy way to leave Advantage and return to original Medicare (supplements are a separate issue). It doesn't matter if the MA plan had a PDP or not.
However, there is a special type of Advantage plan that does not fall into the HMO/PPO category called Medicare Medical Savings Accounts (MSA). MSA's never include a PDP so they can enroll in a stand-alone PDP.

That gets a person back to regular Medicare from the Feds. But, does it also let you enroll in a Medigap plan without having to meet health standards? The 'gap' in Medigap can be rather big.

 

[REWahoo]

That gets a person back to regular Medicare from the Feds. But, does it also let you enroll in a Megigap plan without having to meet health standards?

Hint: No!

 

[Chuckanut]

Hint: No!

That's what I thought.

I've avoided Medicare Advantage Plans because I've heard its hard to revert to Medigap. After seeing what my knee surgery cost and what I paid, and taking into account how I could pick my own surgeon from binders full of good surgeons in my area, I will stick with Medigap for now. Maybe if our country (USA) can get a handle on health care costs, I might reconsider in the future. I'm not holding my breath.

 

[wolf]

It is not Walmart that is the crook, It is Humana! They are the ones you have the plan with and send the premiums to.

You are correct. It's Humana! Crooks.

 

[John Galt III]

Google "Part D Catastrophic Coverage" and read up on the four phases of Medicare Part D.

After googling, it looks to me like there is * no * drug plan, either a 'regular medicare Part D' or a Medicare Advantage drug plan, that limits your max oop if you want to use certain drugs. (Even after you go thru the donut hole in catastrophic coverage in Part D). Maybe one could use cheaper drugs that approximate the use of the more expensive ones. But both Part D and MA drug plans leave you with a roulette game of hoping you never need an expensive drug. The wording in the websites I read to find this out is just awful. So byzantine, overly complex and mind-numbing.

 

[Chuckanut]

The crooks are the ones who let USA pay many times more for a drug than people in other first wold countries do. Also, they keep things as Rx only when others can buy them more cheaply OTC. Voltaren is a good example. Also, basic antibiotics for an infected toe which I got in Italy at la farmacia without having to pay the expense of seeing a doctor.

 

[MBSC]

Enrolling in a stand-alone PDP is an easy way to leave Advantage and return to original Medicare (supplements are a separate issue).

That gets a person back to regular Medicare from the Feds. But, does it also let you enroll in a Medigap plan without having to meet health standards? The 'gap' in Medigap can be rather big.

That's why I said supplements are a separate issue. There is no Medigap underwriting if you live in NY or CT.

Otherwise, there are two "trial rights".

1) You enrolled in an Advantage plan at age 65, have been in the plan less than 12 months, and want to go on OM. You can get any available Medigap plan without underwriting. At 12+ months, Medigap underwriting applies.

2) You were in OM with a Medigap, switched to MA for the first time, been in MA less than 12 months, and want to go back to OM. You get your old Medigap plan/carrier back without underwriting. If your old Medigap is no longer open to enrollment, you can choose from Medigap plan letters A, B, C, F, F-HD, K or L without underwriting. These are the minimum federal requirements. Some companies, like UHC, are more lenient and let you apply for any plan letter they sell but can change this internal policy at any time. At 12+ months, Medigap underwriting applies.

 

[John Galt III]

That's why I said supplements are a separate issue. There is no Medigap underwriting if you live in NY or CT.

Otherwise, there are two "trial rights".

1) You enrolled in an Advantage plan at age 65, have been in the plan less than 12 months, and want to go on OM. You can get any available Medigap plan without underwriting. At 12+ months, Medigap underwriting applies.

12 months? Good! I thought it was only 6 months.

 

[Sunset]

The crooks are the ones who let USA pay many times more for a drug than people in other first wold countries do. Also, they keep things as Rx only when others can buy them more cheaply OTC. Voltaren is a good example. Also, basic antibiotics for an infected toe which I got in Italy at la farmacia without having to pay the expense of seeing a doctor.

I agree.
Occasionally I'll buy something in Canada, OTC that would require a doc visit and prescription here, and in Canada it costs 1/2 cent per pill. (and they are still making a profit)

 

[kaneohe]

Signed Up Today For Walmart Value Rx Plan

Humana rep told me yesterday to call back at 8AM today to sign up (8AM in each time zone). Just as a trial I called at 7AM. The phone system asked for the zip code to "route me to the correct specialist". I didn't know if they were going to keep me on hold till 8AM or not so I tried their automated phone line which promised to sign me up. I went thru several minutes after detailed disclosures before I gave up and decided to try online at medicare.gov.

I don't like to do financial things online but I was pleasantly surprised by the process. Since Medicare went to the new Medicare number system, they just asked for that (no SSN). The rest was just name , address,etc with birth date perhaps the most sensitive info....... Whether you wanted payment w/h by SS or paid to Humana.................there were disclosures too but you could skim at your own speed instead of listening to some voice droning on forever.

Now I just have to hope that the autopayments for the old Humana plan stop in January and are replaced by the new plan amounts..........I understand that the cancellation of the old plan is automatic with the new enrollment and that the new payment has to be set up again. Can't be too sure tho w/ Humana.

 

[REWahoo]

Now I just have to hope that the autopayments for the old Humana plan stop in January and are replaced by the new plan amounts..........I understand that the cancellation of the old plan is automatic with the new enrollment and that the new payment has to be set up again. Can't be too sure tho w/ Humana.

You should get something in the mail in a few weeks confirming your change.

 

[marko]

FWIW, I think I just signed up for Humana Walmart for $13.20.

I say I 'think' because after filling out the on-line form and agreeing to everything and hit 'next' and it said "we cannot process your application at this time; please try again later".

Then, I backed out one page and hit 'next' again and it said "thank you for signing up, here's your confirmation number etc etc".

So, I'll wait a week or two and see what happens. I printed that confirmation number so I have that much. Just odd.

 

[Bestwifeever]

Humana is doing some tricky switching and re-naming this year which I find troubling. They renamed the Walmart plan "Walmart Value Plan" and moved the Walmart Plan people to the pricier $56 Humana Premier plan. But you can undo the switch by enrolling in the new "Walmart Value Plan" which I'm doing. It looks like they did some re-naming and unrequested switching just to see who is paying attention.

See page 8 of your "Annual Notice of Changes" regarding the name change. Also, the "Walmart Value Plan" is not mentioned in the "Annual Notice of Changes" and you have to go online (Humana site) to see it. But it's there and available and is basically your current Walmart Plan re-named and now called the "Walmart Value Plan". What shysters! They're running a real shell game this year!

Regarding your (and others) current zero or low drug expenditures, that has no bearing on the premium. It's insurance covering FUTURE needs.

Thanks, I just went online to find the newly named "Humana Walmart Value Rx Plan" for $13.20 a month; DH's prescriptions filled at the preferred provider Walmart will come to $6 per month. My low drug expenditures are relevant only to my own decision, as I don't have that variable to compare plans with. Very sneaky of Humana to rename our current plan "Humana Walmart Rx Plan" to become "Humana Premiere Rx Plan" yet offer the Value version above for less than a third of the cost.

I went to Medicare.gov to research the plans and pricing. We'll go with the "Humana Walmart Value Rx Plan" next year.

 

[wolf]

Humana rep told me yesterday to call back at 8AM today to sign up (8AM in each time zone). Just as a trial I called at 7AM. The phone system asked for the zip code to "route me to the correct specialist". I didn't know if they were going to keep me on hold till 8AM or not so I tried their automated phone line which promised to sign me up. I went thru several minutes after detailed disclosures before I gave up and decided to try online at medicare.gov.

I don't like to do financial things online but I was pleasantly surprised by the process. Since Medicare went to the new Medicare number system, they just asked for that (no SSN). The rest was just name , address,etc with birth date perhaps the most sensitive info....... Whether you wanted payment w/h by SS or paid to Humana.................there were disclosures too but you could skim at your own speed instead of listening to some voice droning on forever.

Now I just have to hope that the autopayments for the old Humana plan stop in January and are replaced by the new plan amounts..........I understand that the cancellation of the old plan is automatic with the new enrollment and that the new payment has to be set up again. Can't be too sure tho w/ Humana.

In the same situation. Just to clarify.

1. You are already a Humana Part D member.
2. Humana website. To slow, so.
3. You went to Medicare.gov site to change your Humana plans.
From Humana Premier Rx Plan (2020) to Humana Walmart Value Rx
Plan (2020).
4. Currently on Medicare.gov site. Trying to find the "site" that allows you
to change plans.

5. Does the Medicare.gov site, give you a "confirmation" number", as proof
you signed up.

 

[Bestwifeever]

In the same situation. Just to clarify.

1. You are already a Humana Part D member.
2. Humana website. To slow, so.
3. You went to Medicare.gov site to change your Humana plans.
From Humana Premier Rx Plan (2020) to Humana Walmart Value Rx
Plan (2020).
4. Currently on Medicare.gov site. Trying to find the "site" that allows you
to change plans.

5. Does the Medicare.gov site, give you a "confirmation" number", as proof
you signed up.

Look here https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage about a third of the way down for how to join a drug plan. Hope this helps.

 

[kaneohe]

In the same situation. Just to clarify.

1. You are already a Humana Part D member.
2. Humana website. To slow, so.
3. You went to Medicare.gov site to change your Humana plans.
From Humana Premier Rx Plan (2020) to Humana Walmart Value Rx
Plan (2020).
4. Currently on Medicare.gov site. Trying to find the "site" that allows you
to change plans.

5. Does the Medicare.gov site, give you a "confirmation" number", as proof
you signed up.

1) yes but I didn't have the impression I had to be one
2) no , not the Humana website, the Humana phone system. Had to wait for undefined time to talk to rep and didn't like have to l i s t e n to l o n g
d r a w n o u t legal disclosures by the alternate automated system.
3) yes
4) don't remember what I did but I didn't have to search...
went to medicare.gov; clicked on find 2020 plans, then went thru the sorting exercise of comparing plans and when
that list comes up, there is a blue button to check plan details and a green button to enroll.

5)yes confirmation number/message at the end which I copy and pasted to
e-mail myself.

 

[frank]

I used to be a humana walmart low cost part d plan and they were playing games with the pricing for years. my brother in law and I signed up for part d one year and the cost was I think 17.20 and I kept checking the plans every year during the open season. my brother in law just figured he was happy with the plan so stay with. I checked the plans 5 years later and I was paying 15. a month and he was still with humana and paying 70. a month because of there name game. he and I both went to aetna last year on the cheap plan. which was good, but is not available this year. aetna changed to wellcare and the comparable plan is about 20 a month. but with checking it out found that wellcare has a plan at 13.8 per month that is comparable to what we had last year with aetna at a cheaper price and similar coverage. long story short the insurance companies are all playing games, but the ones who just don't bother cost and coverage are the ones that get hurt.