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Part D Insurance

 

 

Humana Part D

Licensed Medicare Part D agents represent virtually every insurer in the United States. No one knows the rules and regulations of the Medicare industry better than the local insurance agent.

Medicare Insurance Plans

Choosing Your Ideal Medicare Part D Insurance Coverage




Get the most out of your Medicare Part D plan by tailoring it to fit your particular drug expenses.


These government plans are confusing, even for educated professionals, so consulting a Part D specialist is valuable.

The sheer number of options available can confuse even those who are well-versed in Medicare policies, so it as always a good idea to consult a Medicare Part D specialist before choosing a plan.

Whichever healthcare provider you choose for your Medicare D coverage, the plan should be suited to your specific personal requirements.

These reasonably-priced plans reduce your overall healthcare costs and provided your yearly prescription rates are less than $2,250, they will cover all your prescription expenses.

 

 


Start by calculating your prescription drug costs as if you have no Part D plan. You are officially in the coverage gap or "Donut Hole" once the full yearly retail value of these items reaches $2,250.

Help that is available to fill in the Part D gaps.
Considerations to make when choosing Part D plans.


NAMI - National Association of Medicare Insurers

NAMI offers millions of Medicare recipients several high quality benefits for the various Medicare, Medicare Part D and Advantage plans available on the market.

medicare-part-d-plans

Medicare Part D Service Log

Which is the Right Part D Plan?


Discussing your requirements with a reputable, qualified Medicare agent will help with your choice. A little research will ensure you don’t lose out later on, and possibly save you money.

You can save over 60% with the right Medicare D plan, depending on your annual expenditure. More information about Medicare D plans in 2013.

Medicare D Coverage
 

Available Medicare D Options

If your prescription drug expenditure is under $2,250, a basic plan will usually suffice.

Premiums range as per customer requirements, but you can expect to pay between $12 per month for a basic plan to $30 for more comprehensive coverage.

If the retail value of your prescriptions exceeds $2,250 you must consider paying more for Medicare supplemental plan gap coverage, although this will usually save you money in the long-run.

The Coverage Gap:

  • A pharmacist will advise you as to your yearly prescription retail costs without Part D coverage. You can then use this information to ascertain which type of plan you will need to opt for.
  • If you exceed the $2,250 threshold, you enter the ‘Donut Hole’ where most Part D plans’ coverage ends up until your expenses reach the ‘Catastrophic Coverage’ limit of $5,100 when coverage resumes.
  • During this time, you are still required to pay your monthly premiums, despite loss of coverage.

Beware of choosing the wrong plan, as many over 65’s end up going over the coverage limit and paying 100% of costs plus premiums..

Choose your policy based upon rates. Medicare coverage is standardized, whereas rates will vary. Choosing a Medicare policy during the open enrollment period and it could well be your retirement years’ most vital decisions.

More about Medicare Part D

Medicare Part D has grown steadily in popularity since the plan was introduced in 2004. These useful policies offer those aged 65+ extra coverage towards their prescription drug costs or the entire yearly amount.

Medicare Part D Benefits

Provided your prescribed medication meets the criteria which class it under ‘generally prescribed medication’, then you will be covered under Medicare Part D. You may have to pay some out of pocket costs, or your medication may be covered in its entirety, depending on your situation.

How Medicare D works: the beneficiary is covered for 75% of their medication, provided their annual expenditure surpasses the relatively low threshold of $250 (known as the ‘deductible’).

Should drug costs exceed $2,250, the beneficiary is responsible for payment of all drug costs, until a total of $5,100 is spent, ensuring catastrophic conditions are covered.

 

 

Medicare Supplemental insurance is intended to compensate its customers for out of pocket costs, with Medicare D covering for prescription drug expenses. The government regulates all Medicare plans, but they are provided by independent companies. For this reason it is wise to research the Part D plans on offer and ensure that they provide coverage for the medication that you require.

If you fail to choose the correct Medicare D policy initially, you may face a penalty for changing it mid-term. Research Part D providers and ensure you have a good foundation of knowledge prior to purchase. Questions worth asking yourself include:

  • » Do I have enough knowledge of how Medicare works before I enter a plan?
  • » Does my chosen plan meet my prescription drug requirements?
  • » What medication do I require and what does it cost?
  • » Is my coverage considered ‘creditable’ by Medicare?

Medicare Part D assists policyholders by giving them several options that help them manage their yearly medication costs. Despite there being several companies offering Medicare D solutions and variations therein, the government presides over the standards to which they all adhere. Supplemental drug plans are entirely optional as an addition to basic Medicare Parts A and B.

2014 Coverage Statistics for Medicare Part D

States
Medicare Part D Eligibility
Stand-Alone PDPs
Medicare Advantage Drug Plans
Employer Plans
Other Prescription Coverages
Known Credible Drug Coverage
United States
44,143,464
56,656,542
4,454,334
3,445,330
3,461,907
56,545,459
Alabama
645,236
253,467
415,364
536,576
158,076
491,267
Alaska
35,765
45,356
535
54,351
5,740
47,345
Arizona
475,065
643,356
394,247
440,310
469,359
748,574
Arkansas
753,354
243,334
33,426
30,243
38,541
426,562
California
3,464,654
3,456,345
2,430,341
227,965
511,597
3,834,590
Colorado
464,627
346,142
343,423
34,364
73,633
185,733
Connecticut
657,543
213,323
35,543
411,558
78,286
454,464
Delaware
235,432
42,345
4,534
21,361
86,459
145,549
District of Columbia
37,643
54,456
3,464
433,252
21,306
59,245
Florida
5,646,556
3,66,534
496,546
350,581
542,441
4,712,095
Georgia
3,533,243
545,343
602,463
135,230
346,475
949,519
Hawaii
340,445
44,434
44,579
6,369
45,345
162,440
Idaho
346,544
64,333
35,730
65,345
34,346
145,744
Illinois
2,345,644
346,564
413,729
464,563
345,343
6,455,356
Indiana
646,567
566,434
69,354
394,681
235,754
645,567
Iowa
754,342
433,143
37,413
45,754
43,230
434,346
Kansas
345,643
644,973
37,539
34,346
35,332
355,459
Kentucky
454,356
645,438
42,752
347,640
23,642
635,45
Louisiana
644,543
355,851
349,465
64,355
23,463
556,658
Maine
245,454
325,247
4,543
34,532
36,633
799,230
Maryland
576,456
546,632
64,346
342,321
345,346
634,451
Massachusetts
3,564,345
146,543
436,354
485,232
246,346
338,450
Michigan
5,454,454
754,246
343,247
341,524
743,324
1,612,548
Minnesota
564,457
704,545
643,343
86,132
64,251
445,745
Mississippi
564,344
683,653
18,568
39,590
43,246
442,096
Missouri
744,346
223,454
350,867
318,545
152,205
815,141
Montana
354,456
46,643
54,013
34,305
26,488
131,039
Nebraska
654,345
251,574
20,501
64,212
39,449
246,456
Nevada
543,346
62,423
65,335
40,457
52,437
270,540
New Hampshire
134,543
95,357
3,532
34,635
30,782
135,595
New Jersey
3,453,454
467,554
245,441
280,258
141,519
1,059,478
New Mexico
454,543
988,656
53,133
23,307
44,574
534,466
New York
3,456,644
958,677
420,318
144,441
249,762
5,34,353
North Carolina
5,424,154
535,456
164,255
612,756
366,464
1,146,341
North Dakota
345,532
64,456
9,452
9,407
413,449
94,168
Ohio
2,456,643
645,454
340,378
548,943
162,722
1,463,112
Oklahoma
466,432
467,447
59,512
34,753
93,656
475,735
Oregon
671,545
345,358
353,484
45,460
75,493
440,746
Pennsylvania
4,653,324
754,457
768,342
350,770
342,761
1,345,363
Rhode Island
246,643
65,457
27,565
32,352
23,717
123,253
South Carolina
354,467
744,454
84,468
218,744
108,435
731,232
South Dakota
643,456
65,4533
4,346
2,655
24,621
135,332
Tennessee
455,456
244,543
453,234
462,448
420,693
834,363
Texas
5,457,566
3,453,432
644,345
423,751
389,432
2,334,243
Utah
765,456
64,343
43,456
31,355
26,132
614,400
Vermont
234,466
64,345
765
78,251
13,448
87,388
Virginia
3,567,454
633,331
345,567
149,159
322,553
875,556
Washington
454,242
564,531
435,356
117,494
413,333
74,550
West Virginia
675,456
145,438
764,021
35,886
33,231
459,376
Wisconsin
544,567
323,564
314,550
134,663
322,345
654,845
Wyoming
54,467
54,343
5,370
3,764
64,332
61,745

How Humana Reached the Top

From Medicare Part D’s conception, Humana had the strategy to use Medicare D plans as a loss leader. It has since become the leading provider of Medicare Advantage plans for over 40 years.

The Advantage plans (also referred to as HMOs) provided by Humana have had a particularly good market share in Florida and Texas since Medicare HMOs were first introduced. The company has demonstrated the value of getting out of the box in a timely manner, despite the risk of every successive client causing financial losses.

We currently have fifteen insurers nationwide who offer Medicare D plans, plus hundreds of agents, regionally, who are working within the industry. Part D providers’ initial marketing and administration costs are particularly high. Once these expenses are dealt with, the potential to make profits is impressive, and the industry is thriving as a result.

This year Humana lost almost $190 for each member who enrolled in their Medicare D plans. This is largely due to the fact that they offered rates that were considerably lower than those of competing companies. By pricing aggressively, Humana was able to grab 24% of the Medicare Part D stand-alone market, as compared to 11.5% of the Part D market share.

As could be expected, prices for Humana policies rocketed for the 2014 calendar year. Mean premiums for Humana Part D jumped from $21.80 to $38.70. Medicare Part D is priced at $41.55 and Part D Medicare comes in at the slightly lower price of $38.80. Humana’s standalone market share coverage has dropped to 18.6% whereas their Medicare Part D policies have increased to a market share of 12.8%.

 

13 Nationwide Insurers

There are currently 13 companies that provide Medicare Part D in all 50 states. They are
(in order of popularlty as of January 1, 2014):

  • 1.  Humana Insurance
  • 2.  United Insurance
  • 3.  Blue Cross/Unicare
  • 4.  Aetna Medicare
  • 5.  Coventry AdvantraRx
  • 6.  CIGNA Medicare Rx
  • 7.  SilverScript Insurance
  • 8.  WellCare Coverage
  • 9.  Sterling Life
  • 10. EnvisionRx Plus
  • 11. United American
  • 12. HealthSpring
  • 13. Health Net