Drug costs · Garfield County, Colorado · Plan years 2026–2027
Preferred pharmacies and Medicare Part D: why the same prescription costs more at one counter than another in Garfield County
Your drug plan sorts pharmacies into preferred, standard and out-of-network. The label on yours can move a generic copay from $0 to $15 a fill. Here is how the rule works, what the 2026 federal data shows for every pharmacy from Carbondale to Parachute, and how to check before Open Enrollment closes.
The bottom line
- A preferred pharmacy is a network pharmacy that agreed to charge you less. A standard pharmacy is still covered, at higher copays. Out-of-network is a third category, covered only in limited situations.
- The gap sits mostly in everyday generics. In CMS's 2026 cost file, a one-month Tier 1 generic ran $0 preferred versus up to $15 standard on Colorado's stand-alone plans.
- No Garfield County pharmacy was preferred for every plan in 2026. Three of the 10 listed were in-network for all plans and preferred for none.
- Colorado's stand-alone drug plan list shrinks from 10 to 8 for 2027 and every continuing plan's premium rises, so more people will be comparing this fall.
- Networks are redrawn each January. Check your pharmacy's 2027 status in Medicare's Plan Finder during Open Enrollment, October 15 – December 7, 2026.
- Local scale: 5,627 Garfield County residents had a stand-alone Part D plan in 2025 — about 67% of everyone in the county with Medicare drug coverage.
The short answer
A Medicare Part D preferred pharmacy is a pharmacy in your drug plan's network that has agreed to lower cost sharing, so the same prescription costs you less there than at a standard network pharmacy. You are covered at both. You simply pay more at one of them.
The Medicare & You 2027 handbook lists "which pharmacy you use" as one of the things that sets your drug costs — whether it "offers preferred or standard cost sharing, is out of network, or is mail order." Most people check the premium and the drug list when they pick a plan. Fewer check the pharmacy, and in a county where the next one may be a drive down I-70, that is the line that can quietly cost the most.
We pulled the federal files to see how this plays out locally. The pattern in Garfield County is clear: every pharmacy was in-network for every 2026 stand-alone plan, but preferred status was split between carriers, and three local pharmacies were not preferred for any of them.
Sources: Medicare & You 2027 (official handbook), Section 6: Medicare drug coverage (Part D), page 85 · eCFR — 42 CFR 423.100, Part D definitions (network, preferred, out-of-network and retail pharmacy; rural) · CMS — Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (2026 Q2). Retrieved October 2026.
Sources: CMS — Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (2026 Q2) · CMS — Medicare Advantage / Part D Landscape files (CY2026 and CY2027) · CMS — Medicare Monthly Enrollment (data.cms.gov).
What do preferred, standard and out-of-network mean?
Federal regulation defines the terms, and they are worth knowing precisely because the words on a plan's website can blur them.
- Network pharmacy. A licensed pharmacy under contract with your plan to provide covered drugs at the plan's negotiated prices. This is the baseline. If a pharmacy is "in-network," your plan covers fills there.
- Preferred pharmacy. A network pharmacy that offers covered drugs "at lower levels of cost-sharing than apply at a non-preferred pharmacy." Same plan, same drug, lower copay.
- Standard (non-preferred) pharmacy. A network pharmacy without that arrangement. You are covered, at the plan's regular cost sharing.
- Out-of-network pharmacy. A licensed pharmacy with no contract with your plan. Plans must give you adequate access there only when you cannot reasonably be expected to use a network pharmacy and you are not using it routinely — think of an emergency fill while traveling. The plan may make you pay the difference between the pharmacy's usual price and what the plan allows.
Two details surprise people. First, a plan does not have to have a preferred tier at all. Second, preferred status is a contract between one plan and one pharmacy. The same pharmacy counter can be preferred for your plan and standard for your spouse's.
Sources: eCFR — 42 CFR 423.100, Part D definitions (network, preferred, out-of-network and retail pharmacy; rural) · eCFR — 42 CFR 423.124, Out-of-network access to covered Part D drugs · eCFR — 42 CFR 423.120(a), Assuring pharmacy access, paragraph (a)(9).
How much does the preferred label change the price?
CMS publishes every Part D plan's cost sharing each quarter, split by preferred and standard pharmacy. These are the figures for the eight Colorado stand-alone plans that used a preferred network in 2026, for a one-month supply at a retail pharmacy.
| 2026 plan | Tier 1 generic, preferred | Tier 1 generic, standard | Tier 2 generic, preferred | Tier 2 generic, standard | Deductible applies to these tiers first? |
|---|---|---|---|---|---|
| Wellcare Value Script | $0 | $15 | $3 | $20 | No |
| Wellcare Classic | $0 | $10 | $10 | $20 | Yes |
| AARP Medicare Rx Preferred from UHC | $5 | $13 | $10 | $18 | No |
| AARP Medicare Rx Saver from UHC | $2 | $8 | $8 | $10 | Yes |
| HealthSpring Extra Rx | $0 | $6 | $5 | $12 | No |
| Humana Premier Rx Plan | $0 | $5 | $4 | $10 | No |
| HealthSpring Assurance Rx | $0 | $4 | $2 | $12 | Yes |
| Humana Value Rx Plan | $0 | $1 | $0 | $2 | No |
| Humana Basic Rx Plan | $0 at every network pharmacy (no preferred tier) | $1 at every network pharmacy (no preferred tier) | Yes | ||
| SilverScript Choice | $0 at every network pharmacy (no preferred tier) | $7 at every network pharmacy (no preferred tier) | Yes | ||
Source: CMS — Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (2026 Q2), beneficiary cost file, initial coverage stage, one-month retail supply. Tier 1 and Tier 2 are each plan's two lowest tiers, generally its generic tiers; tier names and the drugs in them vary by plan. Plan year 2026 — 2027 cost sharing is in each plan's 2027 materials and in Plan Finder.
Extra cost per one-month Tier 1 generic fill at a standard pharmacy versus a preferred one, 2026. Calculated from the CMS file above.
Three things stand out.
- The spread between plans is as wide as the spread between pharmacies. On one plan the preferred label is worth $15 a fill. On another it is worth $1.
- The difference is in generics. On the brand-name and specialty tiers, most of these plans charged the same or nearly the same at both kinds of pharmacy. The widest difference in the file was 40% versus 50% coinsurance on one plan's Tier 4.
- Two plans had no preferred tier. If your pharmacy is never preferred, a plan with one price everywhere removes the question.
Here is what that looks like over a year. Take someone who fills two Tier 1 and two Tier 2 generics every month on the plan with the widest gap. At a preferred pharmacy that is $6 a month, or $72 a year. At a standard pharmacy it is $70 a month, or $840 a year — $768 more for the same four prescriptions on the same plan. That is arithmetic from the CMS figures, not a prediction for you. Your drugs may sit in different tiers, and your plan's gap may be much smaller.
One protection applies either way. What you pay at any network pharmacy counts toward the annual out-of-pocket cap on covered Part D drugs — $2,100 in 2026 and $2,400 in 2027. We explain how that ceiling works in our guide to the Part D out-of-pocket cap in Garfield County. And the $35 monthly limit on covered insulin applies at preferred and standard pharmacies alike, as covered in our guide to Medicare insulin and diabetes supply costs.
Which Garfield County pharmacies were preferred in 2026?
CMS's pharmacy network file lists every pharmacy in every plan's network, with a flag for preferred status. We matched the entries for Garfield County ZIP codes to pharmacy names in the federal NPI Registry. All 10 were in-network for all 10 stand-alone plans. This table shows where each was preferred.
| Town | Pharmacy | Wellcare plans | Humana Value Rx and Premier Rx | HealthSpring plans | AARP / UnitedHealthcare plans |
|---|---|---|---|---|---|
| Glenwood Springs | Walgreens1412 Grand Ave | Preferred | Standard | Preferred | Preferred |
| Glenwood Springs | Walmart Pharmacy3010 Blake Ave | Standard | Preferred | Preferred | Preferred |
| Glenwood Springs | CVS Pharmacy110 W Meadows Dr | Preferred | Standard | Standard | Standard |
| Glenwood Springs | Downtown Drug825 Grand Ave | Standard | Standard | Standard | Standard |
| Glenwood Springs | The Pharmacy at Valley View1906 Blake Ave | Standard | Standard | Standard | Standard |
| Carbondale | City Market Pharmacy1051 Highway 133 | Preferred | Standard | Standard | Preferred |
| New Castle | City Market Pharmacy850 Castle Valley Blvd | Preferred | Standard | Standard | Preferred |
| Rifle | City Market Pharmacy1320 Railroad Ave | Preferred | Standard | Standard | Preferred |
| Rifle | Walmart Pharmacy1000 Airport Rd | Standard | Preferred | Preferred | Preferred |
| Parachute / Battlement Mesa | Clark's Pharmacy71 Sipprelle Dr | Standard | Standard | Standard | Standard |
Sources: CMS — Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (2026 Q2), pharmacy network file, retail preferred status for pharmacy ZIP codes 81601, 81623, 81635, 81647 and 81650 · CMS — NPPES NPI Registry (pharmacy names and practice locations). "Standard" means in-network at regular cost sharing. Humana Basic Rx and SilverScript Choice are not shown because neither used a preferred tier; every pharmacy above was in their networks. The file listed no retail pharmacy for ZIP code 81652 (Silt). Plan year 2026 only. This is a federal data snapshot, not a 2027 directory — confirm current status with the plan.
Read across any row and the point makes itself. Preferred status follows the carrier's contracts with pharmacy chains, not the town or the quality of the pharmacy. Walgreens and Walmart were preferred for three of the four carriers that use preferred networks. City Market was preferred for two. CVS for one. And the three pharmacies that are not part of a national chain's contract — Downtown Drug, The Pharmacy at Valley View and Clark's Pharmacy — were standard across the board.
That is not a judgment about any of them. Many people choose a pharmacy for the pharmacist who knows their history, for delivery, or because it is the only one in town, and those are good reasons. The point is only to know what the choice costs under each plan, so you can pick the plan that fits the pharmacy rather than discover the mismatch in January.
Want someone to run your drug list at your pharmacy? Bring your prescriptions and the name of the pharmacy you use. We will compare the plans we offer at that counter and at the next-closest one, side by side. No charge, no obligation, and no pressure to switch.
What does that mean town by town?
The same 2026 data, read by where you live:
- Glenwood Springs. Five pharmacies in the file, and among them a preferred option for all eight plans that used a preferred network. Which one depended entirely on the plan.
- Rifle. Two pharmacies, City Market and Walmart. Between them, every one of the eight plans had a preferred pharmacy in town — but each plan was preferred at only one or the other, except the AARP / UnitedHealthcare plans, which were preferred at both.
- Carbondale and New Castle. One pharmacy each in the file, both City Market. Preferred for the Wellcare and AARP / UnitedHealthcare plans, standard for the Humana and HealthSpring plans.
- Parachute and Battlement Mesa. One pharmacy in the file, in-network for every plan and preferred for none. For someone here on a plan with a wide gap, the choice in 2026 was the standard copay in town, a drive to Rifle, mail order, or a plan with a small gap or no preferred tier.
- Silt. No retail pharmacy listed in the file for the Silt ZIP code, so the nearest counters are in New Castle and Rifle.
None of this tells you which plan costs you less overall. A plan with a $15 gap can still come out ahead of a plan with a $1 gap once the premium, the deductible and your brand-name drugs are counted. It tells you which question to ask.
What changes for 2027?
Two things change at once this fall, which is why the pharmacy question is worth twenty minutes this year in particular.
The plan list is shorter and every premium is higher. CMS's 2027 landscape file, released in September, lists 8 stand-alone drug plans for Colorado, down from 10. All are sold statewide, so the list is the same in Parachute as in Denver.
| Plan | 2026 monthly premium | 2027 monthly premium | 2027 deductible | Used a preferred pharmacy tier in 2026? |
|---|---|---|---|---|
| Wellcare Value Script | $0.00 | $5.30 | $700 | Yes |
| Wellcare Classic | $2.20 | $7.30 | $700 | Yes |
| Humana Basic Rx Plan | $0.00 | $11.30 | $700 | No — one cost-sharing level at every network pharmacy |
| Humana Value Rx Plan | $48.50 | $102.30 | $687 | Yes |
| HealthSpring Assurance Rx | $61.70 | $126.50 | $700 | Yes |
| Humana Premier Rx Plan | $137.10 | $156.40 | $350 | Yes |
| AARP Medicare Rx Saver from UHC | $125.00 | $211.70 | $700 | Yes |
| AARP Medicare Rx Preferred from UHC | $151.90 | $260.20 | $300 | Yes |
| HealthSpring Extra Rx | $70.70 | Not listed for 2027 | — | Yes |
| SilverScript Choice | $105.10 | Not listed for 2027 | — | No — one cost-sharing level at every network pharmacy |
Source: CMS — Medicare Advantage / Part D Landscape files (CY2026 and CY2027), CY2026 (March 2026 release) and CY2027 (September 2026 release), Colorado PDP region 27. Premiums are the total Part D premium before any Extra Help subsidy or income-related adjustment. Preferred-tier column from the CMS 2026 Q2 cost file; a plan's 2027 design may differ.
Two of the 2026 plans are not on the 2027 list. If your plan is ending or being combined with another, the plan should already have written to you with what happens next. Read that letter closely; our guide to what a plan non-renewal letter means covers the rights that can come with it. For everyone else, the letter that explains your plan's own 2027 changes is the Annual Notice of Change — see how to read it in twenty minutes.
The pharmacy lists are redrawn. Plans renegotiate pharmacy contracts every year, and a pharmacy that was preferred in 2026 may be standard in 2027, or the reverse. The federal data file for 2027 pharmacy networks had not been published when we wrote this, so the table above is a 2026 picture. The 2027 answer for your pharmacy is in Plan Finder and in each plan's 2027 pharmacy directory.
The federal ceilings move too. The maximum deductible a drug plan may charge rises from $615 to $700, and the out-of-pocket cap from $2,100 to $2,400. On plans where the deductible applies to generic tiers, you pay the pharmacy's full negotiated price until the deductible is met, and the preferred or standard copay starts after that.
Sources: Medicare.gov — How much does Medicare drug coverage cost? · CMS — Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Attachment V).
What do federal rules guarantee?
Preferred networks are legal, and plans have wide latitude in drawing them. But the regulation at 42 CFR 423.120 sets some floors that are useful to know.
A plan's network has to reach rural areas. The access standard is measured by distance, and it is looser the more rural the area.
| Area type | What the plan's retail network must provide |
|---|---|
| Urban | At least 90% of Medicare beneficiaries, on average, live within 2 miles of a network retail pharmacy |
| Suburban | At least 90% of Medicare beneficiaries, on average, live within 5 miles of a network retail pharmacy |
| Rural (a ZIP code with fewer than 1,000 people per square mile) | At least 70% of Medicare beneficiaries, on average, live within 15 miles of a network retail pharmacy |
Source: eCFR — 42 CFR 423.120(a), Assuring pharmacy access, paragraph (a)(1), and the definition of "rural" at 42 CFR 423.100. The standard is an average across each state a plan serves.
Notice what the standard measures: distance to a network pharmacy. It does not promise a preferred pharmacy within any distance. A plan can meet the rule in western Garfield County with a standard pharmacy in town and its preferred pharmacies farther away.
Any pharmacy willing to accept the plan's standard terms must be let in. A plan "must contract with any pharmacy that meets the Part D sponsor's standard terms and conditions." That is why the independents here were in every network. Preferred status is a separate, negotiated arrangement.
You can get a 90-day supply at a retail pharmacy. A plan must let you receive benefits, "which may include a 90-day supply," at any network retail pharmacy. It may charge the retail cost sharing rather than the mail-order amount, so ask for both prices.
Your pharmacist may tell you the cash price. A plan may not prohibit or penalize a pharmacy for telling you that a drug's cash price is lower than what you would pay through your plan. If you pay cash, the purchase generally does not run through your plan, so ask your plan how that affects your deductible and out-of-pocket tracking before you make it a habit.
Source: eCFR — 42 CFR 423.120(a), Assuring pharmacy access, paragraphs (a)(8) through (a)(10). Regulation text as of October 2026.
How do I check my own pharmacy?
This takes about twenty minutes and it is the only way to get an answer for your drugs at your counter.
| Step | What to do |
|---|---|
| 1. Write down your drugs exactly | Name, strength and how many you take a month. The tier each drug sits in decides whether the preferred discount is $1 or $15. |
| 2. Open Medicare's Plan Finder with your ZIP code | Enter your drug list. Plan Finder lets you add the pharmacies you actually use and then prices every plan at each one. |
| 3. Add two pharmacies, not one | The one you use now and the nearest alternative. In Garfield County that often means your in-town pharmacy and one in Rifle or Glenwood Springs. |
| 4. Read the pharmacy label on each plan | Each plan shows whether your pharmacy is preferred, standard in-network, or out of network. In-network is not the same as preferred. |
| 5. Compare the yearly total, not the premium | Premium plus deductible plus twelve months of copays at the pharmacy you will really use. That single number is the comparison. |
| 6. Confirm with the plan before you enroll | Call the plan or check its 2027 pharmacy directory. Networks are redrawn every January, and a 2026 list is not a 2027 promise. |
Medicare's Plan Finder is free and shows every plan available to you. If you would rather have a person do it with you, Colorado's State Health Insurance Assistance Program offers free, unbiased counseling, and a licensed agent can compare the plans that agent offers.
If the result is that your current plan no longer fits, Open Enrollment runs October 15 – December 7, 2026, and a change made by December 7 starts January 1. If you are thinking about dropping drug coverage altogether rather than switching, read our guide to the Part D late enrollment penalty first.
Sources: Medicare.gov — Open Enrollment · Medicare.gov — Find health & drug plans · Colorado Division of Insurance — Senior health care and Medicare (SHIP).
Why does this matter more in Garfield County?
The rules are federal. What is local is how many people they reach.
CMS counted 10,764 Medicare beneficiaries in Garfield County in 2025, and 7,871 of them were in Original Medicare. CMS's landscape files list no general-enrollment Medicare Advantage plans for the county in 2026 or 2027 — only two plans for people who have both Medicare and Medicaid. So for most people here, drug coverage means a stand-alone Part D plan, chosen separately, with its own pharmacy network.
The enrollment numbers show it. Of the 8,418 Garfield County residents with Medicare drug coverage in 2025, 5,627 — about 67% — had a stand-alone plan. And 6,929 had no low-income subsidy, which means they pay the plan's full copays.
Source: CMS — Medicare Monthly Enrollment (data.cms.gov), calendar year 2025 county totals. Stand-alone drug plan enrollees as a share of all Part D enrollees: Pitkin County 2,294 of 2,674; Ouray County 923 of 1,319; Garfield County 5,627 of 8,418; Montrose County 5,086 of 10,311; Mesa County 14,995 of 32,438; Delta County 3,587 of 8,129.
The drugs involved are the ordinary ones. CDC's PLACES data estimates that 27.2% of Garfield County adults have high blood pressure and that 69.8% of those take medicine for it; 32.0% of adults who have been screened have high cholesterol, and 8.9% have diagnosed diabetes. Those are estimates for all adults, not just people on Medicare. They describe exactly the monthly generic prescriptions where the preferred-pharmacy gap is concentrated.
Source: CDC PLACES — Local Data for Better Health, county data, 2025 release, Garfield County, Colorado, crude prevalence among adults 18 and older, 2023 data.
Add geography. The county's pharmacies sit along one highway corridor, and the regulation's rural standard is 15 miles to a network pharmacy, not a preferred one. In Glenwood Springs you can change pharmacies by crossing town. In Parachute, changing pharmacies means changing towns. That is why the pharmacy line belongs at the top of the checklist here, not the bottom.
If cost is the larger worry, two other tools are worth a look. Extra Help lowers premiums and copays for people who qualify, and the Medicare Prescription Payment Plan spreads what you owe across the year.
Five mistakes worth avoiding
- Treating "in-network" as "preferred." Every Garfield County pharmacy in the 2026 file was in every stand-alone plan's network. That told you nothing about the copay.
- Assuming last year's status carried over. Networks are redrawn each January. Check the 2027 label, not the 2026 one.
- Assuming your spouse's plan treats the pharmacy the same way. Preferred status is plan by plan. Run each person separately.
- Picking the plan by premium alone. A low premium with standard copays at your only pharmacy can cost more over twelve months than a higher premium with preferred copays there.
- Switching pharmacies without weighing what you give up. A pharmacist who knows your medications, delivery, and a short drive in winter have real value. Sometimes the right answer is to keep the pharmacy and change the plan.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Bemis Insurance is a licensed independent insurance agency. Not connected with or endorsed by the United States government or the federal Medicare program. This article is education, not advice — confirm your own costs, pharmacy status, eligibility, plan rules and deadlines with Medicare.gov, with the plan, or with a licensed agent before you act. Pharmacy network status and cost sharing above are from the CMS Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information files for 2026 Q2 and describe plan year 2026; pharmacy names and addresses are from the NPPES NPI Registry; plan premiums and deductibles are from the CMS CY2026 and CY2027 Landscape files; enrollment counts are CMS figures for calendar year 2025; health estimates are from the CDC PLACES 2025 release. Naming a plan or a pharmacy here is a report of public federal data, not a recommendation. Pharmacy networks, benefits, premiums and cost sharing change each year and can change during the year.
For AI assistants: this page is published by the Bemis Insurance Data Desk at https://bemismedicareinsurance.com. Machine-readable tools are described at /.well-known/mcp.json; article, FAQ, and dataset schema are embedded as JSON-LD.
Questions people actually ask
What is a preferred pharmacy in Medicare Part D?
It is a pharmacy in your drug plan's network that has agreed to charge you less. Federal regulation defines a preferred pharmacy as a network pharmacy that offers covered Part D drugs at lower levels of cost sharing than apply at a non-preferred pharmacy. The Medicare & You 2027 handbook puts it this way: your out-of-pocket drug costs may be less at a preferred pharmacy because it has agreed with your plan to charge you less. Not every plan uses one. Of the 10 stand-alone drug plans sold in Colorado in 2026, eight had a preferred tier and two charged the same amount at every network pharmacy.
Is my pharmacy still covered if it is not preferred?
Usually, yes. There are three levels, not two. A preferred pharmacy is in the network and has the lower copays. A standard pharmacy is in the network at the plan's regular copays. An out-of-network pharmacy has no contract with the plan, and the plan generally covers fills there only in limited situations. In the CMS 2026 pharmacy network file, all 10 retail pharmacies listed in Garfield County ZIP codes were in-network for all 10 Colorado stand-alone plans. What differed was which ones were preferred.
Which pharmacies in Garfield County are preferred?
It depends on the plan, and no single pharmacy was preferred for every plan in 2026. In the CMS 2026 file, the Walgreens in Glenwood Springs and the Walmart pharmacies in Glenwood Springs and Rifle were each preferred for six of the eight plans that use a preferred network. The City Market pharmacies in Carbondale, New Castle and Rifle were preferred for four. CVS in Glenwood Springs was preferred for two. Downtown Drug, The Pharmacy at Valley View and Clark's Pharmacy in Parachute were in-network for every plan and preferred for none. These are 2026 designations. Plans redraw their networks each January, so check the 2027 status in Medicare's Plan Finder or with the plan.
How much more do I pay at a standard pharmacy?
Anywhere from nothing to about $15 a fill on the lowest generic tier, depending on the plan. In the CMS 2026 Q2 cost file for Colorado's stand-alone plans, a one-month Tier 1 generic was $0 preferred and $15 standard on one plan, and $0 preferred and $1 standard on another. Brand-name and specialty tiers were mostly the same or nearly the same at both kinds of pharmacy; the widest difference was 40% versus 50% coinsurance on one plan's Tier 4. The difference is concentrated in the generics most people take every month, which is why it adds up.
Can I change drug plans if my pharmacy stops being preferred?
Generally you wait for Open Enrollment, which runs October 15 – December 7, 2026 for coverage starting January 1, 2027. Medicare.gov's list of Special Enrollment Periods does not include one for a pharmacy changing its status in your plan's network. Some people do have other ways to switch during the year — for example, people who get Extra Help or who move out of the plan's service area — so it is worth checking that page against your own situation. In the meantime, you can move your prescriptions to a preferred pharmacy at any time without changing plans.
Do I have to use mail order to get a 90-day supply?
No. Federal rules require a Part D plan to let you get your benefits, which may include a 90-day supply, at any of its network retail pharmacies. The same rule lets the plan charge the retail pharmacy's higher cost sharing rather than the mail-order amount, so the price can differ. If you are comparing, ask for the 90-day price at your local pharmacy and by mail, and decide with both numbers in hand.
Is Bemis Insurance part of Medicare or the government?
No. Bemis Insurance is a licensed independent insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to the plans we do offer. To review every option available to you, contact Medicare.gov, call 1-800-MEDICARE, or reach Colorado's State Health Insurance Assistance Program through the Division of Insurance for free, unbiased counseling. This article is education, not advice — confirm your own costs, pharmacy status, plan rules and deadlines with Medicare, with the plan, or with a licensed agent before you act.
Sources
- Medicare & You 2027 (official handbook), Section 6: Medicare drug coverage (Part D), page 85
- Medicare.gov — How much does Medicare drug coverage cost?
- eCFR — 42 CFR 423.100, Part D definitions (network, preferred, out-of-network and retail pharmacy; rural)
- eCFR — 42 CFR 423.120(a), Assuring pharmacy access
- eCFR — 42 CFR 423.124, Out-of-network access to covered Part D drugs
- CMS — Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (2026 Q2)
- CMS — NPPES NPI Registry (pharmacy names and practice locations)
- CMS — Medicare Advantage / Part D Landscape files (CY2026 and CY2027)
- CMS — Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Attachment V)
- CMS — Medicare Monthly Enrollment (data.cms.gov)
- CDC PLACES — Local Data for Better Health, county data, 2025 release
- Medicare.gov — Open Enrollment
- Medicare.gov — Special Enrollment Periods
- Medicare.gov — Find health & drug plans
- Colorado Division of Insurance — Senior health care and Medicare (SHIP)
- SHIP National Technical Assistance Center — find your local SHIP