What is the difference between 2013 Medicare Part D plans with Preferred Network Pharmacies and plans with Non-Preferred Network Pharmacies?

First, we need to mention that there is a difference between non-network, network, and preferred network pharmacies. Non-network pharmacies will not provide coverage under your Medicare Part D prescription drug plan. Network pharmacies (both preferred and non-preferred network pharmacies) provide coverage under your Medicare Part D plan.

On the other hand, some 2013 Medicare prescription drug plans include both preferred and non-preferred network pharmacies within the plan’s pharmacy network. And in such a plan, preferred network pharmacies may have lower prices (or cost-sharing) as compared to the plan's non-preferred network pharmacies.

For example, as shown in the chart below, the total prescription co-payment costs (or cost-sharing) for the same three medications (Atorvastatin, Clopidogrel, and Nexium®) can vary between a plan's network pharmacies (such as when you visit CVS or Walmart or Walgreens), depending on the 2013 Medicare Part D prescription drug plan – meaning, you may pay more for your medications at a non-preferred network pharmacy.

Medicare Part D Plan Name	Annual Cost at CVS*	Annual Cost at Walmart*	Annual Cost at Walgreens*	Annual Cost Mail Order*
First Health Part D Value Plus	$1,081	$793	$801	Not Available
AARP MedicareRx Saver Plus	$990	$990	$820	$757
Cigna Medicare Rx Plan One	$1,157	$1,128	$1,170	$1,077
Humana Walmart-Preferred Rx Plan	$3,118	$3,121	$3,130	$3,105
SilverScript Choice	$2,966	$2,966	$3,134	$2,945

*Annual Cost Estimates from Medicare.gov Plan Finder 11/25/2012.

In recent years, this has become an increasingly important topic as more of the most popular Medicare plans no longer have the same cost-sharing for both preferred and network pharmacies.

For 2013, there are 12+ Medicare Part D plan carriers using different cost-sharing for preferred network pharmacies as compared to regular network pharmacies on one or more of their Medicare Part D plans.

Some of these Medicare Part D plan carriers include UnitedHealthcare (AARP), Aetna/CVS, EnvisionRx, First Health, Humana, SilverScript, SmartD, and some of the Blue plans.

Bottom Line: If you want to lower your prescription drug costs, make sure you are using your plan’s preferred network pharmacies (or, if available, the Mail Order option).