Is Medicare and Humana the same thing? Do they both have the same benefits? Does Humana pay more for medication than Medicare?

Question: Is Medicare and Humana the same thing? Do they both have the same benefits? Does Humana pay more for medication than Medicare?

Answer: No Medicare and Humana are not the same.

Humana is one of the largest private insurance companies that provides, along with other products, Medicare Advantage plans and Medicare Part D prescription drug plans.  Humana is contracted with the federal government to provide and administer these Medicare plans under the Medicare program. To learn more about Humana, you can visit their website at www.Humana.com.

Medicare is a governmental program started in 1965 by President  Johnson to provide health care for seniors citizens (over 65) and people receiving disability benefits.

Medicare is operated by the Centers for Medicare and Medicaid Services (CMS) under the US Department of Health and Human Services (HHS).  Medicare coverage includes Medicare Part A (in-patient or hospitalization insurance), Medicare Part B (out-patient and doctor visits), Medicare Part C (Medicare Advantage plans), and Medicare Part D (prescription drug plans).

Medicare does not directly implement these last two programs (Medicare Part C and Medicare Part D) and instead contracts with private firms or insurance carriers (such as Humana) for the purposes of implementation.

Please note that private firms implement Medicare Part C Medicare Advantage plans and Medicare Part D prescription drug plans under the guidance and regulations established by CMS.

Some limited prescription medication is covered directly under Medicare Part A (in-patient drugs) and Medicare Part B (such as physician administered drugs), but the Medicare Part D program was really designed to provide self-administered, out-patient prescription drug coverage for seniors and other Medicare beneficiaries.

Usually Medicare Part A or Medicare Part B would not both cover the same medications as a private Medicare Part D plan.

However, please note:  If you have VA benefits, and you have prescriptions that are available from both the VA and your Medicare Part D plan, you will be able to choose either your Medicare Part D plan or the VA as the source for some of your medications, depending on the cost.

Since not all prescriptions drugs are covered by a Medicare Part D plan and you will need to refer to your current Medicare Part D formulary or drug list for an overview of the covered medications and the cost-sharing for the covered medications.

You can review any Medicare prescription drug plan formulary at: FormularyBrowser.com.

In summary, if you have a Humana Medicare Part D prescription drug plan then you will have some or all of your formulary covered out-patient prescription medication costs covered by the plan.  However, a Medicare Part D plan can change the cost you will pay for a covered prescription drug from year-to-year and you will need to review the details of the current Medicare plan to see the costs of drug coverage.  You can see yearly cost and coverage changes using our Medicare Part D comparison tool:  PDP-Compare.com.

A portion of your medication cost coverage is paid by Medicare and a portion is paid by Humana (for instance, in the Catastrophic Coverage portion of your Medicare Part D plan, the federal government pays for your medication costs).  In addition, a portion of your covered brand-name prescription costs while in the Donut Hole or Coverage Gap are paid by the pharmaceutical manufactures.