Uhm
Uhm v. Humana Inc
Opinion
Opinion
I. FACTS
The Act established Medicare Part D (“Part D”), a volun- tary prescription drug benefit program for seniors. See 42 U.S.C. § 1395w-101 et seq. Under the Act, health insurance providers contract with the Centers for Medicare and Medic- aid Services (“CMS”), part of the Department of Health and Human Services (“HHS”), to offer Part D prescription drug plans (“PDPs” or “plans”) to Medicare beneficiaries. Humana Health Plan, Inc. is a CMS-approved PDP provider; Humana, Inc., its parent company, is not.
In late 2005, the Uhms—Medicare beneficiaries—chose Humana as their Part D provider, based in part on the repre- sentations Humana made in its marketing materials.2 In partic- ular, the Uhms relied on Humana’s representation that they would be enrolled in the benefits plan, and therefore receive coverage for their prescription drugs beginning January 1, 2006, the first day Part D sponsors could provide benefits under the Act.
The Uhms enrolled in Humana’s PDP by filling out the Humana Prescription Drug Plan Enrollment Form. The Uhms chose “Social Security Check Deduction” as their method of premium payment. Accordingly, the $6.90 plan premium was deducted from their…