Key takeaways:
An in-network pharmacy is one that is contracted with your insurance plan to offer lower prices. Preferred pharmacies are also in network and may offer even bigger savings.
To find out if a pharmacy is in your network, check your insurance company’s website, app, or printed materials, or call the customer service number on the back of your card.
Many insurance plans don’t cover out-of-network pharmacies. If they do, you’ll usually pay more or have to pay up front and request reimbursement later.
Prescription medications can be costly, even with insurance coverage. If you’re looking for ways to lower your medication costs, you might already use savings options such as GoodRx to cut down on pharmacy bills.
But one area that’s easy to overlook is the pharmacy itself. Where you fill your prescription can affect how much you pay. Insurance plans often partner with certain pharmacies to secure better prices and offer lower out-of-pocket costs. Choosing an in-network — or even better, a preferred — pharmacy is one of the simplest ways to save without changing your medication, when possible.
What are the different types of pharmacies you can use?
Not all pharmacies are the same. There are different types, and each one serves a different purpose in how you get your medication. The type of pharmacy you use can also affect things such as cost, convenience, and the services available to you. Here are the main types of pharmacies and how they typically work.
Community pharmacies (retail pharmacies): These are your neighborhood pharmacies. They handle most common prescriptions, such as azithromycin (Zithromax) and over-the-counter medications. Community pharmacies include nationwide chain stores and many independent local pharmacies.
Specialty pharmacies: Medications that treat rare diseases and certain chronic health conditions are generally handled by specialty pharmacies. These include medications such as Ibrance (palbociclib), used to treat certain types of breast cancer. You can also get extra support with side effect management and medication counseling when you use a specialty pharmacy.
Compounding pharmacies: When you need customized medications or those that aren’t commercially available, compounding pharmacies can help. They can change the form, adjust certain ingredients, or alter the dose of a medication to fit your needs.
Mail-order pharmacies: Medications can be delivered directly to your home through mail-order pharmacies. They’re convenient for long-term prescriptions, such as spironolactone (Aldactone) for high blood pressure, and often offer cost savings. Many insurers operate their own mail-order pharmacies.
Online pharmacies: These operate fully online and ship medications to your home, either from the U.S. or internationally. Some are safe and licensed, but others may not follow proper safety standards. But you can verify if an online pharmacy is legitimate and works with your insurance plan before filling your prescription. Many online pharmacies are also considered mail-order pharmacies, especially if they’re connected with your health plan.
Facility pharmacies: Hospitals, nursing homes, and other healthcare facilities often have their own in-house pharmacies. They serve people receiving care at those locations; they’re not open to the general public.
Just because a pharmacy carries your medication doesn’t mean it will be covered by your insurance. Plans may only cover medications at certain pharmacies, so it’s worth making sure the one you use accepts your insurance.
What does “in-network pharmacy” mean?
An “in-network pharmacy” is one that has a contract with your specific health plan. In-network pharmacies generally agree to provide medications at discounted rates. Your insurance covers more of the cost when you fill prescriptions at these contracted pharmacies. This helps lower your out-of-pocket costs.
Some insurance plans, but not all, also have “preferred pharmacies.” These are still in the network but may offer even lower prices. Using a preferred pharmacy can lead to lower out-of-pocket costs compared with regular (nonpreferred) in-network pharmacies.
Each insurance plan has its own network of pharmacies. A pharmacy that’s in network for one plan might be considered “out of network” for another. An “out-of-network pharmacy” doesn’t have a contract with your insurance company and may have higher costs. Using an out-of-network pharmacy means you’ll typically pay more for your medications. In many cases, your plan may not cover the medication at all.
To avoid surprise costs and save money, check with your insurer to see which pharmacies are in the network.
How do you find out if a pharmacy is in network?
There are a few simple ways to check if a pharmacy is in network with your insurance plan:
Check your insurance company’s website or app. Most plans have an online pharmacy locator. You can usually search by pharmacy name or ZIP code to see what’s included in your area.
Call your insurance company. You can find the customer service number on the back of your insurance card. A representative can help you find in-network pharmacies. They can also tell you if your plan has preferred options that could save you more money.
Ask the pharmacy directly. When you call or visit a pharmacy, ask if they accept your insurance. They can usually tell you if they’re in network. They can also tell you what your out-of-pocket costs might be if they fill a prescription for you.
Check your insurance materials. Health plans often mail their members a booklet or list that shows which pharmacies are covered. You’ll often receive these materials when you sign up for coverage.
Want to maximize your prescription savings? Combine using an in-network pharmacy with your health savings account (HSA) to help stretch your prescription dollars further.
Your insurance plan has a list of covered medications. Read how your plan’s medication formulary can affect what you pay at the pharmacy.
Some brand-name medications qualify for extra savings if you know where to look. Find out how manufacturer copay cards can help you lower your out-of-pocket costs.
Paying less for your prescriptions is possible. Here’s how to tap into savings programs and get help paying for your prescription medications.
But pharmacy networks can change. Most of these changes happen when your plan renews each year, as insurance companies add or remove pharmacies from their networks. Some changes can also occur midyear if a pharmacy’s contract with your insurer ends. It’s a good idea to confirm the pharmacy network when your plan renews, if you change plans, or before filling a prescription somewhere new.
How do you switch pharmacies?
If you need to switch pharmacies, the new pharmacy can usually handle the transfer for you. Here’s how it works:
Check that the new pharmacy is in network. Before you switch, make sure the new pharmacy is in your plan’s network. See the steps above to confirm this.
Transfer your prescriptions. Call your new pharmacy and tell them you want to move your prescriptions. Give them the name of your old pharmacy and the medication(s) you want to transfer. You’ll also need to give the new pharmacy your full name and date of birth.
Bring your prescription bottles (optional). You can also bring your prescription bottles to the new pharmacy. The pharmacist can use the information on the labels to verify what you’re taking and see which medications still have transferrable refills remaining.
Update your information. Give the new pharmacy your current insurance card and contact information. They’ll need this to process your prescriptions and reach you if there are any issues.
The transfer process may take a day or two. Notify your prescriber of the pharmacy change. This way, they can send any new prescriptions directly to your new pharmacy. Some prescriptions, such as controlled substances, may have stricter rules when it comes to transfer.
If your prescription is out of refills or has expired, your new pharmacy may not be able to transfer it. In that case, they’ll need to contact your prescriber to request a new prescription. This step can take a little extra time, so it’s good to plan ahead.
Which is better: preferred or in-network pharmacy?
If your plan has preferred pharmacies, they’re usually the better choices. Preferred pharmacies are part of your plan’s network. And they may offer extra savings compared with nonpreferred, in-network ones. However, keep in mind that not all plans have a separate preferred pharmacy list.
Insurance companies created the preferred pharmacy option to keep costs down. They negotiate lower medication pricing with these pharmacies. Then, to encourage members to use these preferred locations, insurers offer lower copays or coinsurance. That way, the plan spends less, and you pay less out of pocket.
Regular, or nonpreferred, in-network pharmacies are still a good option. They’re part of your plan’s network and can save you more money than out-of-network pharmacies. But when you use a nonpreferred pharmacy, you may pay more than you would at a preferred location.
The savings between preferred and in-network pharmacies varies by plan. Some plans offer small discounts at preferred pharmacies. Others provide bigger savings per prescription. It’s worth checking your plan to see how much you could save. Still, even small savings can add up. This is especially true if you take multiple medications or fill prescriptions regularly.
Does insurance cover out-of-network pharmacies?
It depends on your plan. In most cases, insurance plans don’t cover out-of-network pharmacies. If you go out of network, you’ll pay the full price for your medication out of your own pocket unless you’re able to lower the cost using savings options such as GoodRx.
Other plans may offer partial coverage for out-of-network pharmacies. But you’ll usually pay much more than you would at an in-network pharmacy.
There are a few exceptions where your insurance might cover an out-of-network pharmacy. These situations include if you’re traveling and can’t get to an in-network pharmacy. Your plan may also provide out-of-network pharmacy coverage during emergencies.
Out-of-network coverage may also apply if the medication you need isn’t available at an in-network pharmacy. In those cases, you may have to pay the full cost up front and submit a reimbursement request. Even then, you may only receive partial reimbursement.
When possible, it’s best to stick with in-network or preferred pharmacies to save on medication costs. If you’re traveling, confirm that you have enough prescription medication to last for your entire trip, if possible. You can also check ahead of time to find in-network pharmacies at your destination in case you need a refill.
The bottom line
An in-network pharmacy is one that has a contract with your insurance plan to offer lower prices. Preferred pharmacies are in network, but they offer lower prices than other in-network options. You’ll usually save more at a preferred pharmacy than at a regular (nonpreferred) one.
To find out if a pharmacy is in network, check your insurance plan’s website, app, or printed materials. You can also call your insurer or ask the pharmacy directly. Most insurance plans don’t cover out-of-network pharmacies, or they only cover part of the cost. If you do go out of network, you may have to pay the full price of the medication or find other ways to save.
Networks can change from year to year or even midyear. Before filling a prescription, confirm that the pharmacy is in your plan’s network.
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References
Academy of Managed Care Pharmacy. (2022). Preferred pharmacy networks.
Drug Enforcement Administration.Transfer of electronic prescriptions for Schedules II-V controlled substances between pharmacies for initial filling. Department of Justice.
Medicare.gov. (n.d.). Getting drugs in a disaster or emergency.
Medicare.gov. (n.d.). What pharmacies can I use?
U.S. Food and Drug Administration. (2025). How to buy medicines safely from an online pharmacy.
Xu, J., et al. (2022). Pharmacy switching in response to preferred pharmacy networks in Medicare Part D. Health Services Research.
