What is a Medicare-Preferred Pharmacy and How To Find One

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Purchasing medications is one of the most expensive parts of healthcare on a day-to-day basis for many people. Medicare Part D covers prescription drug costs. Many Part D plans incentivize the patient to lower their costs. One of the ways people can lower their costs is by using a Medicare-preferred pharmacy. Read on to learn more about what a Medicare-preferred pharmacy is and how to find one. 

Medicare Part D

Medicare Part D is the part of Medicare that covers prescription drug costs. These plans are offered by private insurers around the country. Each plan is different depending on the company and the location. Their formulary is also different. The formulary is the list of generic and brand-name drugs that that plan covers. Formularies normally depend on deals that the insurer has made with different pharmacies and manufacturers. 

What a Preferred Pharmacy Is

One of the ways that insurance companies save money on Part D is by designating certain preferred pharmacies. A preferred pharmacy offers a lower copay for covered drugs than a standard pharmacy. Essentially, insurance companies have made deals with certain pharmacies. These deals allow them to save money by paying less for the medication. The pharmacy benefits from this deal because it is almost guaranteed more business by driving Medicare patients to their pharmacy.

How to Find One

In order to find preferred pharmacies in your area, you need to check with your insurer. For example, if your Part D plan is through Blue Cross Blue Shield, you would check their website and search for preferred pharmacies in your area.

Why It’s Important to Find a Preferred Pharmacy

One of the main reasons it is in your best interest to find a preferred pharmacy is because you need to reduce your healthcare costs. Part D has a coverage gap called the Donut Hole. In 2021, if you and the insurer combined to pay $4,130 for your medications, you are no longer covered fully. From that point, you must pay 25% of the cost of the medication. Once you and the insurer reach $6,550, you are out of the Donut Hole and you only need to pay 5% of the cost. If you keep your costs low in the beginning by using a preferred pharmacy, you will never reach the Donut Hole in the first place. 

To learn more about preferred pharmacies and saving money in Part D, call us at Bobby Brock Insurance today. 

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Justin Brock

President & CEO of Bobby Brock Insurance