Humana reimbursement changes affect Medicare-eligible members

Medicare primary payer rules affect groups with fewer than 20 employees

Effective July 1, 2016, Humana will reduce a Medicare-eligible member’s benefits by the amount that would have been covered if the member were enrolled in Medicare Part B. Those impacted have been notified of this change in a letter from Humana distributed late in 2015.

Humana announces prescription drug changes for 2016

Effective January 1, 2016, Humana will update its prescription drug list (PDL) for small groups 2-99. The changes can range from complete removal from the list of covered drugs, or new requirements impacting quantity, type and authorization.

How to read the annual Drug List change:

Coverage status (CVG):

Certain medications that were previously not covered by your plan will be added to your Drug List for 2016, while other medications will be removed.

+ CVG (addition); CVG (no change); -CVG (removal)

Save money with Humana's paperless billing option

Offer available for groups under 100

Starting with April 2015 invoices, Humana will waive a new monthly administrative fee for eligible groups that enroll in paperless billing and set up automatic payments. Monthly savings can be as much as $25.

To register, login to the secure employer portal on www.humana.com and go to “Billing.” For those who continue receiving invoices by mail, a $25 administrative fee may be added to the monthly invoice.

Blue Cross Blue Shield of Kansas City announces prescription drug changes

Effective March 1, 2015, Blue Cross Blue Shield of Kansas City will update its prescription drug list (PDL) for group members on the Blue-Care (HMO), Preferred-Care (PPO), and Preferred-Care Blue (PPO) plans. Current members will receive communications from BlueKC within the next couple weeks.

Prescriptions moving from Tier 2 to Tier 3

  • Jentadueto (Type 2 diabetes)
  • Tradjenta (Type 2 diabetes)

Prescriptions moving from Tier 3 to Tier 2