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

Answer:

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

Medicare Advantage prescription drug plan

A Medicare Advantage prescription drug plan may have preferred cost-share pharmacies. If you're a Humana member looking for a preferred cost-share pharmacy, access our Pharmacy Finder and enter your ZIP code or Humana member ID to find in-network pharmacies. Preferred cost-share pharmacies display "Preferred Cost Share" in the pharmacy's description under the pharmacy's name.

Medicare prescription drug plans (PDP)

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

Mail delivery: CenterWell Pharmacy™ and PrescribeIT (for Florida Medicaid members) are 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 and Coverage for your state for additional information.

For 2022, the Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of CT, DE, IA, MA, ME, MN, MO, MS, ND, NJ, NY, RI, SD; suburban areas of CT, DE, MA, ME, MN, MT, ND, NJ, NY, PA, PR, RI; 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, MN, MS, ND; 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 1-800-421-7858 (TTY: 711) or consult the online pharmacy directory at Humana.com.

For 2023, the Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of CT, DE, IA, MA, ME, MN, MO, MS, ND, NJ, NY, PR, RI, SD; suburban areas of CT, MA, ME, MN, MT, ND, NH, NJ, NY, PA, PR, RI; 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, MN, MS, ND; 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.