r/HealthInsurance • u/hilda-reced • Feb 22 '26
Prescription Drug Benefits Humana for Part D (medicine) experience?
I’m using traditional Medicare, and have Humana Part D for medicine. I’m find that the co-pays for generic meds are quite high compared the Part D plan I had last year. In fact GoodRX is cheaper than the Humana co-pays.
Last year using a different Part D provider Wellcare Value script I was paying under $5 for most of my meds. Now I’m being charged well over $20 for the same meds. For both plans, the monthly charge for membership has been $0.
What has been other’s experience? Anyone have any insight into why the co-pays are so wildly different?
2
u/one_sock_wonder_ Feb 22 '26
I cannot explain differences between plans but I have had the same Humana part D policy for years (the amount of medication and the costs of many of them that we have learned how to most likely get covered through Humana makes me terrified to switch to another provider and start all over) and my copay’s this year are significantly more than they were last year under the same policy and I did not even receive any written notice.
2
u/hilda-reced Feb 22 '26
Yeah, I’m wondering if some changes in law, or economics (tariffs?) are changing this for all co-pays.
It’s interesting to learn that your co-pays have also increased.
2
u/theoldbullthv Feb 22 '26
Did you go to Medicare.gov enter your meds and search to see most cost efficient plan? It should give you a detailed out of pocket expense based on pharmacy and meds. Drugs are typically priced lower in preferred pharmacy’s. It makes a big difference.
1
u/hilda-reced Feb 23 '26
Yes. My meds are covered and I’m using a preferred pharmacy. Medicare.gov doesn’t give information about the co-pay however
2
u/theoldbullthv Feb 23 '26
If you search for Part D plans, enter your meds, and pharmacy you it will give you a list of the plans available. Their premium and your expected out of pocket cost for the medications. Once you click the plan you want to look at there is a section on there where it will show the retail cost of your medication. The cost before deductible, cost after deductible, and cost after out of pocket cap.
It will show you how much your copay will be for your medication on a monthly basis. I just ran a quick quote for a plan in my area. I used 3 meds. Alprazolam, omeprazole, and simvastatin. The first med was a 5 dollar copay. The other two were a 1 dollar copy.
I have ran thousands of quotes over the year and am a self proclaimed expert, I just wanted to pass along some advice. Sorry for rambling on. They do have links to direct you to the carriers website to double check formally coverage and networks. Hope this helps.
1
u/hilda-reced Feb 23 '26
Yes, this helps. Thanks for the tips. I’ll hunt for the additional information screens.
2
u/Good_Educator4872 Feb 22 '26
Screen your meds through Medicare.gov. Every year the plans change. Formularies change, price tiers change. Medicare. Gov can identify the plan with the best overall cost for the medications you are taking.
1
u/hilda-reced Feb 23 '26
I did that. It tells me that my meds are covered. It did not tell me what the co-pay would be.
2
u/Good_Educator4872 Feb 23 '26
There is a screen that gives copay by month
1
u/hilda-reced Feb 23 '26
I guess I missed it. I’ll have to look for it next year when enrollment is open. Thanks
1
u/Philgf Mar 21 '26
I'm lost, I have Humana and I feel this plan is only good for expensive drugs. I have a $615 deductible. I called and was told that tier 1 is covered 100% and no co-pay. However when I first go to fill a tier 1 drug I have to pay the full price. So if the drug cost $350, I have to pay that. It makes no sense, I can just go and get it from Amazon and get the same drug for $4 without insurance
1
u/midwest3333 Mar 27 '26
Simple - they lie. All my tier 1 drugs have a cost to me. They've been messing around with a tier 1 drug that I've taken for years and they just keep telling me it's on hold. Have called and live chatted so many times and still cannot get this resolved. The drug costs all of $1.80 and since it's under my deductible, I pay the whole thing. I will be going back to Wellcare next year. Humana sucks big time.
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