What Is a Preferred Pharmacy for Medicare Part D?
You can enroll in a Medicare plan that provides the benefits of prescription drugs D to obtain prescribed medications. There are two types of plans offered by private insurance companies approved by Medicare that offer prescription drug benefits for Medicare Part D: A separate Medicare Part D plan for controlled drugs that works in conjunction with Medicare Part A and B insurance, or
A Medicare Advantage Prescription Drug Plan that combines medical and hospital benefits insured by Medicare Part A and Part B with prescription drugs from Medicare Part D.
What are the Medicare Part D pharmacy networks?
When you enroll in the Medicare Part D plan, your plan will provide a network of pharmacies to help you meet your prescriptions. Pharmacy networks may include one or more of the following:
Mail-order pharmacies can prescribe most of the medications you take regularly. Depending on the consultation with your doctor, you can receive a single premium medication of 30, 60 or 90 days. Your prescription medications will be delivered by mail.
Retail pharmacies may include grocery stores, pharmacies, discounted retail stores and/or independent local pharmacies.
“Preferred” pharmacies are included in many Medicare plans that offer protection against Medicare Part D prescription drugs. A “preferred” pharmacy is a retail pharmacy that is one of the retail pharmacies within a network of plans that is commits to charge the cost of income prescriptions. If you choose a Medicare Part D prescription drug plan or a Medicare Advantage prescription drug plan with preferred pharmacies, your out-of-pocket costs may be less than those of a standard pharmacy.
Does my choice of preferred or standard pharmacy affect the costs of my prescribed medications?
In general, the benefits of Medicare prescription drugs are designed so that the plan guarantees the cost of your insured drugs at each network pharmacy. You may have to make an insurance or co-payment after having paid the annual franchise (if the plan has one). Using a preferred pharmacy can potentially save you money. Your additional savings will be derived from a coinsurance or lower payment paid at preferred pharmacies (preferential cost sharing).
The use of preferred pharmacies can work in your favor in two ways:
First, the use of preferred pharmacies can reduce the cost of prescribed medications.
Second, the lower costs of prescribed medications can help you delay the insurance gap (e.g. donut hole) if you are taking many remedies and/or expensive brands.
How do you choose a Medicare plan that guarantees insurance for prescription drugs?
Remember that 2019 Medicare Supplement Plans don’t offer Part D prescription drugs define your monthly premiums, define your benefits, and sign contracts with pharmacies. The benefits, costs and networks of pharmacies generally differ by plan. Therefore, it is advisable to make a comparison of the available plans for the drugs prescribed by Medicare Part D. Make sure your medication is in the plan formula (list of insured prescription drugs). In addition, you may want to check if the plan has favored pharmacies and what other economic resources the plan offers.