| Tue, Sep 20, 2011 @ 09:00 AM

Which Pharmacies May I Use with Medicare?

Posted by Medicare Made Clear

Be sure to review Medicare Part D plans carefully so you know which pharmacies are covered by each plan.Many Medicare beneficiaries choose to take advantage of prescription drug coverage. Medicare prescription coverage is available through standalone Medicare Part D prescription drug plans and as benefits included in some Medicare Advantage plans. In order to make this coverage available, private insurance companies will generally contract with pharmacy networks. If you are considering Medicare prescription drug coverage, be sure to review your prospective plans carefully so you know which pharmacies are covered by each plan. Many plans have geographic limitations, while some are limited to certain pharmacy stores or chains.

How Location Can Affect Your Medicare Prescription Coverage

Each Medicare prescription drug plan is limited by geographic location. Some plans allow beneficiaries to visit pharmacies nationwide while others are limited to specific states or regions. If you rarely travel outside of your community or state, a localized Medicare drug plan might be right for you. If you frequently travel out of state, a plan with nationwide prescription coverage may be better suited to your needs.

Out-of-Network Exceptions

Although each Medicare prescription plan has geographic limitations, most offer out-of-network options for emergencies. While you will likely face higher costs to fill your prescriptions out-of-network, your plan may help cover some of your emergency costs.

When reviewing prescription coverage plans, be sure to pay special attention to out-of-network considerations:

  • Does the plan offer limited coverage?
  • Do you feel you might need a plan with greater out-of-network coverage?
  • Be sure to select the plan that meets your needs for coverage of out-of-network prescription costs.

Mail Order Prescriptions

One benefit offered by many Medicare prescription drug plans that you might find convenient is a mail-order pharmacy service that allows them to have prescriptions delivered to you by mail. It is important to keep in mind that some mail-order services require the purchase of 90 days’ worth of prescriptions at a time. If this is something you feel you cannot afford, you can look for plans that allow you to order a 30-day supply of your prescriptions, or stick with a plan that allows you to purchase your prescriptions over the counter.

Using the Medicare Plan Finder

Medicare.gov offers a helpful Medicare Plan Finder that allows you to learn about the plans available in your area, as well as other important details such as participating pharmacies, covered medications and more.

When you use the plan finder:

  • Plans can be sorted by premiums, deductibles and plan ratings.
  • You can compare plans based on estimated annual costs, premiums, copays, coinsurances, coverage restrictions and plan ratings.

When comparing Medicare prescription drug plans, be sure to keep each plan’s restrictions in mind to avoid surprises down the road and find the plan that’s best for you. Check out the Medicare Plan Finder today and begin comparing plan options.

For more information contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE(1-800-633-4227), TTY 1-877-486-2048. You can also contact Medicare Made Clear to learn more at 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.


Learn More About Medicare Part D – MMC

The Basics of Medicare Part D – Medicare.gov

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