Guide to Medicare Part D: Can I Get My Prescription Filled At a Pharmacy That Is Not Within my Part D Plan's Network?

 

Each plan has a list of participating pharmacies. You should always try to stay within the network of participating pharmacies.

You may be able to obtain your drug from a non-network pharmacy, BUT ONLY IF:

• You cannot reasonably be expected to obtain your drug at a network pharmacy,

  And

• You do not use a non-network pharmacy on a regular basis.

Otherwise, your Part D plan can refuse to cover your prescription at a non-network pharmacy.

NOTE: Some plans allow you to use out-of-network pharmacies, but you will have to pay any difference between the cost of the drugs at an in-network pharmacy and the out-of-network pharmacy. Check the plan notes to determine if your plan allows this option. Some plans can be used nationwide. Anyone who travels out of state regularly should consider joining a plan that provides nationwide coverage. If travel is an important part of your life, ask about the geographical coverage of any plan you are considering.