Humana Changes formulary yearly to lower their own costs. Lexington, Kentucky

.... and, no, I don't work for Humana.

I work for a major Chicago hospital as Director of Billing/Coding and have done so for almost fifteen years. I have Humana insurance as part of my job, but that's as close as I am to them.

You obviously work for Humana or something.  If Humana has no control over where they place their drugs on their tiers then why is it that they have tier change request forms for the patient and doctor to fill out and then they either switch it or not at their own discretion?  I don't claim to be an insurance expert and I would certainly never be so rude or act like I am so superior when I don't know all the circumstances about a person's predicament.  



I can tell you for an absolute fact that I pay them $110/month for prescription insurance only and then I pay for most of my meds as well.  I am not in the least embarrassed.  I have been disabled most of my adult life so I have spent a lot of time going over all aspects of the Medicare program.  I think it is a little odd that the meds that get switched to a higher tier each year always include the ones I'm taking that year. 



I work out a new plan with my doctor so that I can continue to get the meds that closest resemble the ones I require most and that I can afford only to have to repeat the process as soon as the new year begins.  I can't count the times my doctor has tried to give me a prescription to help my quality of life and to control the most extreme of my symptoms only to get to the pharmacy and find out that Humana won't cover any of it or they won't cover enough of it that I can afford to get it.  My prescription costs went from $20 a month to $120 a month from 2010 to 2011 and none of my prescriptions changed in any way.  My premium also went up $10 a month. 



I don't ask you to care but I would appreciate a little respect for a difference of opinion.  I was under the impression this was to inform and give people an insight into things they might not otherwise know to help them make an informed decision about what will be most beneficial to their lives and the lives of their families.  I didn't know it was an opportunity for immature contributors to bash people for telling the truth so that others might learn from it without having to find out the hard way.  It was not my intent to offend in any way.  I sought only to inform with my experience and learn from other's experiences. 

They did the exact same thing to my husband after being reassured at the beginning of the year that the tiers will not change.
Call Humana and always ask for a manager, demand a tier exception form for each medication. Take that form to your doctor and hopefully with his help they will drop medication back to tier one. Also let people in your community know.

Tell people about your experiece in the pharmacy line, loud. Go to the senior centers and let them know. Write your congressmen, know it's a waste of time but documentation is important.
 
Report them to the AMA and the Better business bureau. Talk to pharmacy that makes the meds you need and see if they have any programs that can help.

I have AARP Secure Horizons and they have been wonderful! Hope this helps.