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

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This page is part of our Guide to Medicare Part D.

Each plan has a list of participating pharmacies. You should always try tostay 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.


Reviewed August 2009

This online guide was adapted with permission from Maine Legal Services for the Elderly. We extend our thanks to them.