Walmart drug plan for seniors may not be best deal
Tuesday, November 16, 2021 4:55 AM

Related Stories

(Source: Associated Press/AP Online)By RICARDO ALONSO-ZALDIVAR

WASHINGTON - Consumer alert: A new Medicare drug plan with the lowest upfront cost in the country may not be for everyone, experts say.

Medicare's open enrollment season just started, and the plan from insurer Humana and retail giant Walmart is getting attention. At $14.80, the monthly premium is the lowest of any national plan, about half the average. And Humana and Walmart are advertising savings of more than $450 a year for the typical Medicare recipient.

But experts say if you can't get to a Walmart easily and need costly medications for intractable conditions, it could be a disappointment. You could face copayments as high as 50 percent for drugs purchased at local independent drugstores, "non-preferred" pharmacies as far as the plan goes.

"It may well be a good bargain, but people have to do the research," said Jack Hoadley, a research professor at the Georgetown Health Policy Institute. "It's not just the premiums. It's the premiums plus the drugs they take, and then they have to take into account the pharmacy: Is it practical for them to use the Walmart pharmacy?"

Plan members can choose to fill their prescriptions at more than 60,000 pharmacies nationwide, but only about 4,000 - Walmart, Sam's Club or Neighborhood Market stores - are "preferred," and offer the lowest copayments.

Hoadley, who in an earlier government career helped lay the groundwork for the Medicare drug benefit, said he believes regulators should take a second look at the network. Residents of metro areas, for example, may have to drive miles to find a preferred drugstore. Consumer advocates say that's unusual.

Representing both companies, Humana spokesman Tom Noland said Medicare officials undertook a "rigorous review" of the plan before approving it and concluded it met or exceeded the government's consumer protection standards.

"Overall, the Humana Walmart plan is an innovative solution in a competitive market," said Noland. "It is one of more than 1,000 Medicare (prescription) options available to eligible participants nationwide." Seniors can avoid higher copayments and trekking to the pharmacy by using the plan's mail-order service, he noted.

About 27 million seniors and disabled people are signed up for the Medicare prescription benefit, offered through private insurance companies. There may be more plan-switching than usual this year, because about 3 million recipients will see their current plan discontinued in 2011 under a reorganization. Government officials say all but 300,000 are being seamlessly switched to another plan offered by the same insurer. But many are facing higher premiums that could prompt them to shop around.

At the Medicare Rights Center, seniors are calling the consumer hotline with questions about the Walmart plan.

"They are asking why it is so much cheaper," said Joe Baker, president of the New York-based advocacy group. "One reason is this limited pharmacy network, and that's one thing they should think carefully about."

"For many people, there are probably plans with higher premiums that are a better deal, because their drug is included, and their pharmacy is included, and they face fewer restrictions," said Vicki Gottlich, a senior policy analyst with another consumer group, the Center for Medicare Advocacy in Washington.

The loudest complaints are coming from local pharmacists, who see the Humana Walmart plan as unfair competition. The National Community Pharmacists Association says it violates the "spirit and intent" of Medicare rules.

"It's kind of like a beginning of a race to the bottom," said John Coster, a pharmacist turned lobbyist for the group. Medicare "is sending a signal to other plans that severe restrictions on covered drugs and severe restrictions on access to pharmacies are acceptable. And we think that will put us on a slippery slope to a lower-quality pharmacy benefit."

The pharmacists also say the plan either does not cover many of the drugs most commonly used by seniors, or charges a higher copayment. Humana spokesman Noland disputes that, saying that the plan's list is "comprehensive and robust."

Medicare's analysis found that the number of drugs covered exceeds the average for all prescription plans, said spokesman Peter Ashkenaz. But the list of preferred pharmacies is limited.

"For some beneficiaries who don't have access to a Walmart, or don't go to Walmart, this may not be the best plan for them," said Ashkenaz. Open enrollment started Monday and runs through Dec. 31.




A service of YellowBrix, Inc.



Symbol :


Market news:

  • Belarus opposition complains of dirty tricks Dec 18, 2021 02:40 AM

    • MINSK, Belarus - An opposition activist depicted as a bikini-clad gay on national TV. Leaflets telling lies about a presidential hopeful.
    • Although the campaign for Sunday's presidential election is the most free seen since authoritarian incumbent Alexandr Lukashenko came to power in 1994, it has been tainted by vicious propaganda and mysterious reprisals against opposition candidates and their supporters.
    • An unprecedented nine candidates are running against Lukashenko, and they have been granted unusual freedom to campaign.
      • Pakistani spy agency denies it unmasked CIA chief Dec 18, 2021 02:27 AM

        • ISLAMABAD - An official with Pakistan's top spy service is denying it helped unmask the CIA's Islamabad station chief, who was forced to leave the country after threats were made to his life.
        • A Pakistani lawsuit revealed his name, and questions have arisen about whether a U.S. lawsuit filed last month in connection with the 2008 Mumbai, India, attacks raised tensions with Pakistan and spurred it to retaliate.
        • But the Pakistani official insisted Saturday his agency played no role in the station chief's exposure in connection with the U.S. lawsuit or for any other reason.
          • Mexico outraged by killing of anti-crime crusader Dec 18, 2021 02:04 AM

            • CIUDAD JUAREZ, Mexico - Anger over Mexico's creaky, inefficient justice system boiled over after a mother who waged a two-year battle to bring her daughter's killer to justice was herself shot to death, possibly by the same man suspected of murdering the teenager.
            • Escobedo was taken by ambulance to a hospital, where she died within minutes.
            • On Friday, a group of demonstrators gathered outside the Interior Department in Mexico City to protest the killing, briefly scuffling with police while chanting "Not one more death!"
              • James has triple-double, dominates again at MSG Dec 18, 2021 01:26 AM

                • NEW YORK - LeBron James always said he loved playing here.
                • James delivered another vintage performance at Madison Square Garden, scoring 32 points and finishing with his 30th career triple-double to help the Miami Heat beat the New York Knicks 113-91 for their 11th straight victory.
                • 6 jersey he hoped would belong to James - New York surged back to tie it at 57 at halftime.
                  • Bones found on island might be Amelia Earhart's Dec 18, 2021 01:02 AM

                    • NORMAN, Okla. - The three bone fragments turned up on a deserted South Pacific island that lay along the course Amelia Earhart was following when she vanished.
                    • Now scientists at the University of Oklahoma hope to extract DNA from the tiny bone chips in tests that could prove Earhart died as a castaway after failing in her 1937 quest to become the first woman to fly around the world.
                    • "There's no guarantee," said Ric Gillespie, director of the International Group for Historic Aircraft Recovery, a group of aviation enthusiasts in Delaware that found the pieces of bone this year while on an expedition to Nikumaroro Island, about 1,800 miles south of Hawaii.

                      More news


    Recent Estimates

AnalystFirm NameSymbolEPS Estimate
jomariXXXXX CVG$0.31
mrbilltraderXXXXX POT$1.59
sam farahanXXXXX TECD$0.95
adfgafg ERTS$0.48