Is Your Pharmacy In-Network?

Is Your Pharmacy In-Network?

Is Your Pharmacy In-Network?

It makes sense to find out if your health provider is in the network before you make an appointment. When you use an in-network care provider and facility, you get the most from your health insurance plan. The same is true with your pharmacy, too. When you use a pharmacy that is in network, you’ll save money.

With some prescription drug plans there can be an extra consideration. Along with in-network and out-of-network pharmacies, you also may have what’s called a preferred pharmacy network.

If a preferred pharmacy network is part of your benefits, you’ll save the most money when you fill your prescriptions at preferred pharmacies. 

Here’s a quick overview to help you understand the differences.

Preferred Pharmacy*

In-network Pharmacy

Out-of-network Pharmacy

Most cost savings

Lowest out-of-pocket

Some Savings

Lower out-of-pocket

No savings

Highest out-of-pocket

$

$$

$$$

*Does not apply to all pharmacy benefit plans. See your plan materials for details.

Find a Network Pharmacy

To find an in-network pharmacy, sign in to myprime.com   or call the number on the back of your member ID card.

Move Your Current Prescriptions

If you’ve been using a pharmacy that isn’t in-network, it’s easy to switch. To move an existing prescription or remaining refill to a new pharmacy, do one of the following:

1. Take your prescription bottle/bag to your new pharmacy
2. Call your new pharmacy and ask them to contact your current pharmacy
3. Ask your doctor to contact your new pharmacy

Fill New Prescriptions

Ask your doctor to send any new prescriptions to your new network pharmacy. Bring your member ID card with you if it’s your first visit to the pharmacy or if you have changed health insurance plans.

Learn more about the Preferred Pharmacy Network.

Prime Therapeutics LLC is a pharmacy benefit management company contracted by BCBSNM to provide pharmacy benefit management and related services. In addition, contracting pharmacies are contracted through Prime Therapeutics. The relationship between BCBSNM and contracting pharmacies is that of independent contractors. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. Myprime.com is an online resource offered by Prime Therapeutics.  

Originally published 2/1/2017, Revised 2018, 2019, 2021

Anonymous
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