What is the difference between a preferred cost-share and standard cost-share pharmacy?


Preferred cost-share pharmacies may provide prescriptions for our Medicare members at a lower cost than standard in-network cost-share pharmacies, depending on the plan.

Medicare Advantage prescription drug plan (MAPD)

Beginning in 2023, all Humana MAPD plans will have a single retail network in which you’ll no longer need to differentiate between standard and preferred cost-sharing retail pharmacies. This means you’ll have the same drug coverage no matter where you fill your prescriptions, as long as the retail pharmacy is in-network. You can find in-network retail pharmacies by accessing our Pharmacy Finder and entering your ZIP code or Humana member ID. You’ll also be able to find mail-order options for your plan.

Medicare prescription drug plans (PDP)

Retail: All Humana’s Medicare PDP plans have preferred cost-share retail and mail-order pharmacies. Visit our Humana Walmart Value Rx Plan™, Humana Premier Rx Plan™ and Humana Basic Rx plan™ pages for more information.

Mail order: CenterWell Pharmacy™ is the preferred cost-share pharmacies for the Humana Walmart Value Rx Plan™, Humana Premier Rx Plan™ and Humana Basic Rx plan™.

Cost sharing varies by state or region. Refer to the Summary of Benefits for additional information.

The Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of AR, CT, DE, IA, IN, KY, MA, ME, MI, MN, MO, MS, NC, ND, NJ, NY, OH, RI, SD, TN, WI, WV; suburban areas of CT, MA, ME, MI, MN, MT, ND, NH, NJ, NY, OH, PA, PR, RI, WV; and rural areas of IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: DE, ME, MI, MN, MS, ND, OH; suburban areas of MT and ND; and rural areas of ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.