Violation of Medicare regulation

I switched to Humana for my Medicare HMO (or advantage plan). I switched to them for one very specific coverage. They would have covered it, but the bottom line was it really was not obtainable due to medical norms.

Now I have had there coverage since January 1, 2016; I promise you I will have another company on Jan 1, 2017. Initially I thought they were just incompetent, with more and more experience I believe they are very competent, finding ways to make me pay more than I did last year (and could have continued to pay this year had I stayed with United Health).

I believe Medicare essentially has established 5 categories for prescription drug coverage. but the co-pay is more or less up to the companies #1 preferred generic (co pay of $9) #2 non-preferred generic ($15 dollar co pay) #3 Preferred BRAND ($22) #4 Non-preferred BRAND (co pay $65) #5 something called CO-INSURANCE. The company pays between 33% to 50% and you are stuck with the rest. I recently filled a prescription that was a generic, Bupropion, the brand name is Wellbutrin. Now the book they gave me lists the the class’ of drugs I mentioned above.

When I went to pick it up, the co-pay was $22! I paid it and then called Humana. After about 15 minutes I was told “while it is generic, it’s an expensive generic”. So the table they sent me was not true. It may or not be a violation of Medicare regulation. I’m sure they put the required information in one of the pages of very small print. Which lead to my other “issue”. I pay an extra $35 dollars per month to have the “Gold” plan. Which lowers co-pay to my primary care doctor (actually there is no-copayment and specialists from $50 in the base plan to $20). I have gone to my doctor 3 times so far in 2016.

Each time when I’ve gone, they asked for a $10 co-pay. One time I can understand, but when they were told (and they agreed) I had no co-pay, they still have not updated their computers – which tells me they are at the least sneaky and in my opinion just plan crooked. I think they do that so when the doctor asks for the $10 they hope people will pay it and they owe the doctor less.

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Reported Loss :120 $
Severity of Scam :Extremely High
Reported by : Anonymous
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