How to check whether your pharmacy is in your plan's network
A plan's drug prices depend on where you fill the prescription. Here's how to check that a pharmacy you can actually use is in the network — and preferred.
Networks have two tiers
A plan's pharmacy network isn't just in or out. Most plans split it into preferred and standard pharmacies, and the same drug on the same tier can cost less at a preferred pharmacy than at a standard one in the very same plan. A pharmacy fully out-of-network usually isn't covered at all except in limited situations.
Check a pharmacy you'll actually use
The convenient answer isn't always the cheap one — the drugstore on your corner might be standard while a pharmacy a few minutes further is preferred. Before enrolling, check that a pharmacy you're willing to use regularly is in the network, and ideally preferred.
Check it here, by ZIP
Every plan page on this site with drug coverage has a "Pharmacies near you in this plan's network" card: enter your ZIP and it lists in-network retail pharmacies within about 35 miles, closest first, with preferred ones flagged and a "preferred only" filter — built from the CMS monthly pharmacy-network file. It also lists the plan's mail-order pharmacies.
Consider mail order
For drugs you take every day, a plan's mail-order pharmacy often has the lowest cost sharing, frequently for a 90-day supply. If you take regular maintenance medications, compare the mail-order price against your local pharmacy — it can change which plan is cheapest for you.
Not every plan uses preferred pharmacies
Some plans have no preferred pharmacies at all — every in-network pharmacy costs the same. That's not worse; it just means the preferred/standard distinction doesn't apply. The plan pages here say so when a plan has none.
Confirm before you enroll
Pharmacy networks are set each plan year and can change. Before enrolling, confirm your pharmacy's status with the plan or on Medicare.gov, which prices your drugs at the specific pharmacy you choose.