However, preferred network pharmacies usually have lower cost-sharing as compared to standard network pharmacies - meaning, you may pay less for your prescriptions at a preferred pharmacy as compared to a standard pharmacy - and you can see some actual Medicare plan cost-sharing examples below.
As an example of different cost-sharing between network pharmacies, the chart below shows the variation between preferred and standard network pharmacies for the 2021 California SilverScript Choice (PDP) plan.
| California SilverScript Choice (S5601-064) | ||||||
| 30-Day Supply Cost-Sharing | 90-Day Supply Cost-Sharing | |||||
| Preferred Pharmacy | Standard Pharmacy |
Preferred Mail-Order |
Preferred Pharmacy | Standard Pharmacy |
Preferred Mail-Order |
|
| Initial Coverage Phase Cost-Sharing (before Donut Hole) |
||||||
| Tier 1 - Preferred Generic: | $0.00 | $5.00 | $0.00 | $0.00 | $15.00 | $0.00 |
| Tier 2 - Generic: | $5.00 | $10.00 | $5.00 | $15.00 | $30.00 | $15.00 |
| Tier 3 - Preferred Brand: | $35.00 | $47.00 | $35.00 | $105.00 | $141.00 | $105.00 |
| Tier 4 - Non-Preferred Brand: | 39% | 39% | 39% | 39% | 39% | 39% |
| Tier 5 - Specialty Tier: | 28% | 28% | 28% | n/a | n/a | n/a |
Note: The preferred and standard network pharmacy cost-sharing can vary by state.
You can use our Rx$ icon on our PDP-Finder or MA-Finder to see the cost-sharing details for all tiers and pharmacies for any Medicare Part D or Medicare Advantage plan with prescription drug coverage.
Here is another example of how coverage costs can vary between preferred and standard pharmacies. The chart below shows the variation between preferred and standard network pharmacies for the 2021 WellCare Classic plan.
| Texas WellCare Classic (PDP) (S4802-013) | ||||||
| 30-Day Supply Cost-Sharing | 90-Day Supply Cost-Sharing | |||||
| Preferred Pharmacy | Standard Pharmacy |
Preferred Mail-Order |
Preferred Pharmacy | Standard Pharmacy |
Preferred Mail-Order |
|
| Initial Coverage Phase Cost-Sharing | ||||||
| Tier 1 - Preferred Generic: | $0.00 | $1.00 | $0.00 | $0.00 | $3.00 | $0.00 |
| Tier 2 - Generic: | $1.00 | $2.00 | $1.00 | $3.00 | $6.00 | $2.50 |
| Tier 3 - Preferred Brand: | $35.00 | $42.00 | $35.00 | $105.00 | $126.00 | $87.50 |
| Tier 4 - Non-Preferred Brand: | 35% | 45% | 35% | 35% | 45% | 35% |
| Tier 5 - Specialty Tier: | 25% | 25% | 25% | n/a | n/a | n/a |
Since 2012, more Medicare Part D plan have been moving toward adopting using different cost-sharing models for preferred pharmacies as compared to standard network pharmacies.
As an example, in New Jersey Medicare Part D prescription drug plans had only seven (7) Medicare Part D plans in 2012 that included standard and preferred pharmacy pricing. This number of Medicare plans increased to 15 plans in 2013 - and in 2019, 24 of the 26 New Jersey stand-alone Medicare Part D prescription drug plans use preferred and standard pharmacy pricing.
Nowadays, about 85% of all 2025 stand-alone Medicare prescription drug plans (PDPs) will use different cost-sharing for preferred vs. standard (non-preferred) network pharmacies (as compared to 93% of all PDPs in 2024). More specifically, 453 stand-alone 2025 Medicare prescription drug plans will offer additional cost-sharing savings if you shop at one of their preferred network pharmacies.
And a bit of Part D history...
For a historical perspective, you can see a complete list of all 2013 plans (stand-alone prescription drug plans and Medicare Advantage plans) that are using preferred network pharmacy pricing in our article, "2013 Sees Increase in the Number of Medicare Part D Plans Using Preferred Network Pharmacy Pricing" on this site. You can also click here to read more about the cost differences between preferred network and standard (non-preferred) network pharmacies in 2013.
For more information about preferred and standard network pharmacy cost sharing, please also see our article: Will preferred pharmacy pricing save you money in 2024?
Choosing a preferred network pharmacy when using the Medicare.gov Plan Finder
After choosing your medications, the Medicare.gov Plan Finder allows you to choose pharmacies in your local area as a reference to check prices across the various Medicare Part D plan options.
Tip: If you selected your Medicare prescription drug plan using the Medicare.gov Plan Finder – and the pharmacy you selected is not a preferred pharmacy you will be shown the higher "standard" network pharmacy prices and not the preferred pharmacy prices - so you will need to look closely at the Plan Finder to determine whether your chosen pharmacies are preferred or standard.
If you are not certain about an additional charge at a network pharmacy, please telephone your Medicare plan’s Member Services department to locate a preferred network pharmacy in your area or contact Medicare for more information about preferred pharmacy pricing by calling 1-800-633-4227 (1-800-Medicare).