Part D plans contract with pharmacies at two or three price levels. Preferred pharmacies usually have the lowest copays. Standard network pharmacies are still “in network” but cost more. Out of network is an emergency setting, not a weekly habit.
Keeping a neighborhood apothecary is often the right life decision and the wrong assumption. Ask whether that store is preferred, standard, or absent on the plan you are about to sign. A five-dollar difference per fill is sixty dollars a year on one maintenance drug and several hundred on a stack of them.
Mail order is not automatically cheaper. Some plans want 90-day fills at preferred retail. Some want mail. Extra Help copays still apply, but the pharmacy network can change whether you pay the Extra Help preferred rate or a higher one.
When you search on ThriftMeds, add the pharmacy you actually use. The estimate is built to move when the network status moves. If you split fills between a big chain and an independent, check both. The plan that looks best at one counter can reverse at the other.