What is the difference between 2014 Preferred Network Pharmacies and Network Pharmacies?

The good news is that both preferred and network pharmacies are included in a Medicare Part D prescription drug plan’s pharmacy network.

However, preferred network pharmacies have lower cost-sharing as compared to “non-preferred” network pharmacies.

Both our PDP-Finder and MA-Finder now show a note (!) if a plan uses preferred network pharmacy pricing – meaning the cost-sharing is different if you purchase your medications from a preferred network pharmacy as compared to a "non-preferred" network pharmacy.

As an example, the chart below shows the variation between preferred and “non-preferred” network pharmacies for the 2014 Georgia Humana Walmart Rx plan:

Georgia Humana Walmart Rx Plan (PDP) (S5884-156-0)
30-Day Supply Cost-Sharing			90-Day Supply Cost-Sharing
Preferred Pharmacy	Non- Preferred	Mail- Order	Preferred Pharmacy	Non- Preferred	Mail- Order
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic:	$1.00	$10.00	$1.00	$3.00	$30.00	$0.00
Tier 2: Non-Preferred Generic:	$4.00	$33.00	$4.00	$12.00	$99.00	$0.00
Tier 3: Preferred Brand:	20%	25%	20%	20%	25%	20%
Tier 4: Non-Preferred Brand:	39%	50%	39%	39%	50%	39%

Note: The preferred and network pharmacy cost-sharing on the Humana Walmart Rx plan varies by state. You can use our new 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.

As an example of how this different cost-sharing could affect you, the chart below shows how the total prescription costs for three popular medications (Atorvastatin, Clopidogrel, and Nexium®) can vary between network pharmacies (such as CVS, Walmart, or Walgreens), depending on your 2014 Medicare Part D plan.

Bottom Line: you may pay more for your medications at a “non-preferred” network pharmacy.

2014 Medicare Part D Plan Name	Annual Cost at CVS*	Annual Cost at Walmart*	Annual Cost at Walgreens*	Annual Cost Mail Order*
AARP MedicareRx Saver Plus	$1,008	$802 (P)	$826 (P)	$734
Humana Enhanced	$1,387	$1,242 (P)	$1,286 (P)	$1,082
United American - Enhanced	$1,752 (P)	$1,743 (P)	$1,996	$1,726

*Annual Cost Estimates from Medicare.gov Plan Finder 11/09/2013.
(P) This is a preferred network pharmacy for the designated Medicare Part D plan

Please note that more 2014 Medicare prescription drug plans no longer have the same cost-sharing for both preferred and network pharmacies.

In fact, 707 stand-alone 2014 Medicare prescription drug plans will offer additional cost-sharing savings if you shop at one of their preferred network pharmacies.

So as can be seen in the chart below, 19 Medicare Part D plan carriers in 2014 are using different cost-sharing for preferred network pharmacies as compared to regular network pharmacies on one or more of their Medicare Part D plans.

2009-2014 Preferred Pharmacy Count

Some of the new Medicare plan entries now using a 2014 preferred pricing structure for include:

the WellCare plans,
the Cigna Medicare Rx plans,
the MedicareRx Rewards plans,
the HealthMarkets plans,
Symphonix Rite Aid Value Rx plan, and
many new "Blue" (Blue Cross / Blue Shield) plans.

These 2014 plans are joining with the 2013 Medicare Part D plans that will continue to used preferred pharmacy pricing in 2013 including:

the UnitedHealthcare (AARP),
Aetna/CVS,
First Health,
Humana, and
United American plans that already have preferred pharmacy pricing.

Again, the Bottom Line: If you want to lower your 2014 prescription drug costs, make sure you are using your Medicare Part D plan’s preferred network pharmacies (or, if available, the Mail Order option).