It is important for licensed sales agents to understand how the Insulin Savings Program works, who is eligible, and what Humana plans to participate in the program. Failure to properly explain aspects of the Insulin Savings Program can lead to member complaints to both Humana and Medicare as well as corrective action, member dis enrollment from the plan, and/or potential commission chargebacks.

The Part D Senior Savings Model

It is important for agents to understand that CMS requires that the Insulin Savings Program is first introduced as the “Part D Senior Savings Model”.  When speaking to members or prospective members, licensed sales agents must introduce this program as “The Part D Senior Savings Model”, which Humana calls the Insulin Savings Program, and may then refer to the program as the Insulin Savings Program throughout the remainder of the presentation.

How the Insulin Savings Program Works

There are 25 select insulins on the ISP formulary which are manufactured by Novo and Sanofi.  Participating insulins will be listed within the Rx Calculator with the Insulin Savings Program listed as one of their parameters.

For each select insulin, eligible members will automatically pay no more than:

•  $35.00 for a 1-30-day supply,
• $70 for a 31-60 day supply, and
• $105.00 for a 61-90-day supply. 

This price extends through the first three stages of the Part D prescription drug benefit (deductible, initial coverage and coverage gap). Note: Because insulin pens and vials are sold in specific package sizes that cannot be broken apart (e.g. 5 pens per box), the member may not be able to get an exact 30-day or 90-day supply based on how much they use each day.

Insulins administered with a pump are NOT ELIGIBLE because they are paid through the Part B benefit.