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 than standard in-network cost-share pharmacies, depending on the plan.

Medicare Advantage prescription drug plan (MAPD)

All Humana MAPD plans have a single retail network which 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: Some of Humana’s Medicare PDPs have preferred cost-share retail and mail-order pharmacies. Visit our Humana Value Rx Plan™ and Humana Premier Rx Plan™ pages for more information.

Mail order: CenterWell Pharmacy™ is the preferred cost-share pharmacies for the Humana 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.

For 2024, The Humana Premier RX Plan (PDP) and the Humana Walmart Value RX Plan (PDP) Prescription Drug Plan pharmacy networks include limited lower-cost, preferred pharmacies in urban areas of AR, CT, DE, IA, IN, KY, MA, MI, MN, MO, ND, NJ, NY, OH, RI, SD, TN, WI, WV; suburban areas of CT, DE, HI, IN, MA, MI, MN, MT, ND, NJ, NY, OH, PA, PR, RI, WI, 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, MI, MN, 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.

For 2025, The Humana Premier RX Plan (PDP) and the Humana Value RX Plan (PDP) Prescription Drug Plan pharmacy networks include limited lower-cost, preferred pharmacies in urban areas of AR, CT, DE, IA, IN, KY, MA, MI, MN, MO, ND, NJ, NY, OH, RI, SD, TN, WI, WV; suburban areas of CT, DE, HI, IN, MA, MI, MN, MT, ND, NJ, NY, OH, PA, PR, RI, WI, 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, MI, MN, 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