Preferred Pharmacies for 2015 Medicare Prescription Drug Plans

Preferred Pharmacies for 2015 Medicare Prescription Drug Plans

Many of the Medicare Prescription Drug Plans (PDP) for 2015 have preferred pharmacy pricing--meaning members will pay a reduced (or sometimes no) co-payment for prescriptions filled at one of the plan's preferred pharmacies. Below you will find the plans that have preferred pharmacy pricing, the corresponding preferred pharmacies, and breakdowns of how co-payments differ between preferred and non-preferred pharmacies. If a PDP is not listed below, it does not use preferred pharmacy pricing. When referencing SHINE's Massachusetts Stand Alone Medicare Drug Plans chart, please note that the co-payments given reflect the preferred pharmacy pricing if the plan has preferred pharmacies.

Aetna Medicare Preferred Pharmacies: CVS pharmacies

Aetna Medicare RX Saver

Tier 1: Generic Tier 2: Preferred Brand Tier 3: Non-preferred Brand Tier 4: Specialty Tier 5: Select Care Drugs

Preferred Pharmacies

$0 $3 $45 37% 25%

Other Network Pharmacies $2 $5 $45 37% 25%

All AARP Plans Preferred Pharmacies: Walgreens, Safeway, Kroger, Target, Stop and Shop, Publix, Hannaford, Wegmans, Sam's Club, Walmart

AARP MedicareRx Preferred

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$3 $5 $40 $75 33%

Other Network Pharmacies $5 $9 $45 $95 33%

Rev. 10/10/14

AARP MedicareRx Saver Plus

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $2 $20 $40 25%

Other Network Pharmacies $2 $4 $35 $50 25%

Blue Medicare Rx Value

Preferred Pharmacies: CVS Pharmacy, Stop & Shop

Blue Medicare Rx Value Plus

Preferred Pharmacies

Tier 1: Preferred Generic

$1

Tier 2: Non-Preferred Generic

$6

Tier 3: Preferred Brand

$35

Tier 4: Non-Preferred Brand

40%

Tier 5: Specialty

25%

Other network pharmacies $6 $16 $45 50% 25%

Blue Medicare Rx - Premier

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Any Pharmacy

$4 $9 $30 $70 25%

Other network pharmacies

Cigna HealthSpring Preferred Pharmacies: K-Mart, Kroger, Stop & Shop, Target, Walmart and many others

Cigna-HealthSpring Rx Secure

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand

Tier 5: Specialty

Preferred Pharmacies

$1-2 $3-7 20% 30-40%

25%

Other network pharmacies $4-6 $9-15 22-24% 35-45%

25%

Cigna-HealthSpring Rx Secure-Xtra

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $4 20% 35% 33%

Other network pharmacies $4 $10 22% 40% 33%

Rev. 10/10/14

Cigna-HealthSpring Secure-Max

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $2 $30 $85 33%

Envision Preferred Pharmacies: Big Y, Medicine Shoppe, Osco

Envision Rx Plus Silver

Tier 1: Generic Tier 2: Preferred Brand Tier 3: Non-Preferred Brand Tier 4: Specialty

Preferred Pharmacies

$2 15% 37% 25%

Other network pharmacies $4 $8 $40 $95 33%

Other network pharmacies $10 25% 42% 25%

Express Scripts Preferred Pharmacies: Walgreens

Express Scripts Medicare Value

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$0 $2-8 17-23% 48% 25%

Other Network Pharmacies $3 $8-14 19-25% 50% 25%

Express Scripts Medicare Choice

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $5 $40 48% 31%

Other Network Pharmacies $8 $16 $45 50% 31%

Rev. 10/10/14

First Health Part D

First Health Part D Essentials Preferred Pharmacies: CVS and various independent pharmacies

First Health Part D Premiere Plus

Tier 1: Preferred Generic Tier 2: Preferred Brand Tier 3: Non-Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$0 $3 $45 50%

33%

Other Network Pharmacies $4 $7 $45 50%

33%

First Health Part D Value Plus Preferred Pharmacies: CVS, Walmart

First Health Part D Value Plus

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$0

$3 $35 50% 25%

Other Network Pharmacies $3

$7 $35 50% 25%

Humana Note: Each Humana Plan uses a different network of preferred pharmacies Humana Walmart Rx Preferred Pharmacies: Walmart, Sam's Club

Humana Walmart Rx

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $4 20% 35% 25%

Other Network Pharmacies $10 $33 25% 50% 25%

Rev. 10/10/14

Humana Enhanced Preferred Pharmacies: Walgreens, Walmart, Sam's Club

Humana Enhanced

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$3 $7 $42 44% 33%

Other network pharmacies $7 $12 $45 50% 33%

Humana Preferred Rx Preferred Pharmacies: Walmart, Sam's Club

Humana Preferred Rx

Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Preferred Pharmacies

$1 $2 20% 35% 25%

Other network pharmacies $2 $4 25% 36% 25%

SilverScript Preferred Pharmacies: CVS/pharmacy, Wal-Mart, Walgreens, Target, Kroger, Rite Aid, Duane Reade, Costco, Publix, Safeway, Sam's Club, Big Y, Shaws & many more various independent pharmacies

SilverScript Plus

Tier 1: Generic Tier 2: Preferred Brand Tier 3: Non-Preferred Brand Tier 4: Specialty

Preferred Pharmacies

$0 $24 40% 33%

Other network pharmacies $7 $31 50% 33%

Transamerica Medicare Rx Preferred Pharmacies: None for 2015

Transamerica Medicare Rx Value Classic Tier 1: Preferred Generic Tier 2: Non-Preferred Generic Tier 3: Preferred Brand Tier 4: Non-Preferred Brand Tier 5: Specialty

Network Pharmacies

$0 $8 $45 50% 25%

Rev. 10/10/14

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