MEDICARE COSTS REQUIREMENTS: All Medicare patients receive a prescription at a pharmacy within a 30-minute drive of their home or work location.
All patients must be able to show identification at the pharmacy and fill prescriptions with a U.S. postal or Medicare card.
The pharmacies may not charge more than $50 for a prescription.
Most Medicare patients can also fill their prescriptions online.
If you or someone you know needs an emergency or life-saving medication, call your primary care physician.
If your physician has a referral, you may be able be billed for an appointment or appointment over the phone, with no doctor visit required.
See your doctor’s office for more information.
Medicare will pay for most prescriptions if they are filled online or in person.
The price you pay for a medicine or medication may not be included in the price of the medication, so be sure to check with your pharmacist for details.
A pharmacy’s pharmacy benefits manager (PBM) may be a trusted source of information about how much a medication costs, how much it will cost you if you choose not to pay, and what you should expect if you do pay.
See the PBM for more details.
In some states, you will pay a higher price than the cost for the drug if you have an emergency and don’t have a Medicare card or Medicare Prescription Drug User Fee Card (PPDUFA).
For more information on PBM, see Medicare’s Drug and Device Benefits FAQ.
To see how much your Medicare prescription will cost, see How much is my Medicare prescription?
How do I get an extra rebate?
You will not be charged extra for a new prescription unless you request one.
Your Medicare prescription benefits manager may offer an extra $10 rebate for every additional prescription that you take from an PBM.
See how to get an additional rebate.
How much does a generic prescription cost?
You can get a generic drug for less than the price for a full-strength prescription.
See our generic prescription guide.
How do we calculate my Medicare Part B rebate?
Your Medicare Part A rebate can be calculated using the formula for Part B drugs (see Part B drug rebates).
You can also check with the PPMUFA website for more help with Part B Drug Rebates.
Medicare Part C rebates can be used for Part C drugs.
See Part C drug rebays.
What if I get a prescription from a different pharmacy?
If your prescription was sent to a different PBM than the one that you received, you should report this to your PBM in the next step.
How will I know if my Medicare drug plan pays for the prescription?
Medicare Part D and Part B will cover your prescription.
You must fill your prescription using a Medicare prescription card.
If a Medicare Part F prescription is not filled in time, you must report this.
Medicare must pay the full price for your prescription and the cost of the PBN prescription fee.
How can I get my prescription covered?
To check your Medicare Part-D or Part-B prescription coverage, see our Part D or Part B coverage guide.
What can I do if I don’t pay my prescription?
You may be charged a fee for your unused prescription at the PAM or your local pharmacy.
You can pay the fee at a time when your prescription is still being processed.
Medicare pays for most medications without a prescription, and your PPM can provide more information about your prescription’s costs and coverage.
To learn more about Medicare Part N, see Part N. If I do not have a prescription for a particular drug, I should have one.
You may want to contact your health plan if you are uninsured or underinsured.
The Medicare Part P program covers many drugs for which you do not need a prescription and will help you manage your costs.
You will be able pay Part P at a local pharmacy and can find your local PBM on the PAMS website.
You also may want help paying your Part D drug bill or Part D PBN drug bill if you don’t use Medicare Part K. The Part P Program has a prescription assistance program to help you pay Part B and Part D drugs, and you can learn more on the Part P website.
For more help, call Medicare at 1-800-318-2521.
How does Medicare pay for my Medicare benefits?
Medicare will cover the following items when you pay your Part B prescription: Your deductible for Part D prescription drugs (for example, the deductible for the COVID-19 medication you are taking for COVID);