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Filling your prescriptions

 

Fill your prescriptions at a network pharmacy

Fill your prescriptions at a network pharmacy

In most cases, your plan requires you to use a pharmacy in the network to fill your prescriptions. Our pharmacy network includes:

 

  • Major retail pharmacy and grocery store chains, such as CVS, Walmart and Costco
  • Local independent pharmacies
  • Mail order services through CVS Caremark® Mail Service Pharmacy

Use our Find a Pharmacy tool to find in-network pharmacies near you.

 

To get started, just enter your ZIP code.

Sometimes you can save money by asking your doctor to prescribe the generic version of a brand-name medicine. Generic versions of brand-name drugs:

 

  • Have the same active ingredients in the same amounts
  • Typically cost less
  • Are declared by the Food and Drug Administration to be just as safe and effective

There are time guidelines for refilling your drugs.

 

At a retail pharmacy:
 

  • For a 30-day prescription, order a refill when you have a 7-day supply left.
  • For eye-drop medication, order a refill when you have a 9-day supply left.

 

Through a mail-order pharmacy:
 

  • For a 100-day prescription, order a refill when you have a 22-day supply left.
  • For eye-drop medication, order a refill when you have a 27-day supply left.

 

If you order too early, the pharmacy won’t give you the refill until the approved date.

 

You can get prescription drugs shipped directly to your home. Often, mail-order drugs arrive within 7 to 10 days. Call the number on your ID card if you don't get your mail-order drugs within this time. You can also sign-up for automated mail-order delivery.

 

Medicare only covers prescription drugs sold, filled and used in the U.S. and its territories.

We have a broad network of over 65,000 pharmacies, with more than 23,000 preferred locations. You should regularly check our drug pricing tool to make sure you’re using the best pharmacy based on the drugs you take. Switching pharmacies is easy. Just follow these 3 simple steps:

 

  1. Get a list of your existing prescriptions and the last pharmacy that filled them.
  2. Contact your new pharmacy and provide them with the list so they can start the transfer process.
  3. Follow up with the new pharmacy to make sure the transfer was successful.

In limited circumstances, Medicare allows you to use an out-of-network pharmacy to fill your prescriptions. See the Using an out-of-network pharmacy section below for more information.

If you take medications regularly, our mail order pharmacy may be a great option for you. CVS Caremark® Mail Service Pharmacy is our network mail order service. Using mail‐order delivery is convenient and may even help you save time and money. Check our drug pricing tool to confirm this is the best option for you.

 

Your medicine is securely packed, then mailed quickly to you. You can expect to get your prescription drugs within 10 business days from the time we receive your order. And if you don’t receive your order within this timeframe, you can call us. Our number is on your ID card.

 

To refill your mail-order prescriptions, just call us at the number on your ID card. You can also sign-up for automated mail‐order delivery.

 

 

Note: Your formulary shows the drugs covered by your plan. And it will tell you if a medication is available for mail order.

 

 

For information on how to get started with mail order, click the Learn more about mail order button below.

 

Learn more about mail order

Our network specialty pharmacy focuses on medicines that aren’t usually available at retail pharmacies. It offers:

 

  • Injection supplies, like needles, syringes, alcohol swabs, adhesive bandages and containers for needle waste at no extra cost to you
  • Fast delivery at no extra cost
  • Package tracking
  • Delivery to your home, doctor’s office or place of choice
  • Support and education to help you use your medicines and manage your health condition
  • Flexible payment options
  • Information on drug maker programs that offer financial help

There may be times when you need to use an out-of-network pharmacy:

 

  • There’s no network pharmacy close or open 24 hours
  • You need a prescription drug that nearby network or mail-order pharmacies don’t often stock, like drugs for rare medical conditions
  • You get a Part D prescription drug from an out-of-network provider pharmacy from:
    • An emergency room
    • A provider-based clinic
    • An ambulatory surgical center
    • An outpatient setting
  • You get a prescription outside of your home or service area due to:
    • A state or federal disaster declaration
    • Other public health emergency

If one of the above reasons doesn't apply, we won’t reimburse you for your prescription filled out of network.

 

If one of the above reasons applies, you'll have to pay the full cost when filling the prescription. You may get a smaller amount of your medicine until you can get to a network pharmacy.

 

For reimbursement, send us a claim form and your receipt. We'll reimburse you for the amount you paid up to a 10-day supply, minus your copay or coinsurance.

 

Print a prescription drug claim form

 

Your plan coverage document (Evidence of Coverage) has more details about out-of-network pharmacies.

 

See your Evidence of Coverage

Please see your Evidence of Coverage for:

 

  • A complete description of your prescription coverage
  • Instructions on how to fill your prescriptions
 

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