Walgreens Accepts Medicaid at Most Locations

Yes, Walgreens accepts Medicaid at the vast majority of its stores. However, acceptance depends on which state's Medicaid program you're enrolled in and which specific Medicaid plan you have. Walgreens is an in-network pharmacy for most state Medicaid programs, but some managed Medicaid plans may have different pharmacy networks.

Before you go to Walgreens, check your Medicaid card or plan documents to confirm Walgreens is listed as an in-network pharmacy. If you're unsure, call your Medicaid plan directly or use the pharmacy locator on your plan's website. Some states' Medicaid programs list participating pharmacies online, which you can search by location.

Walgreens also participates in most state Medicaid programs' preferred pharmacy networks, meaning you'll typically pay the lowest copay when you fill prescriptions there rather than at an out-of-network pharmacy.

Key Takeaways

  • Walgreens accepts Medicaid at most locations, but you must verify your specific state plan covers that store before you go.
  • Prescription copays at Walgreens vary by state and by your individual Medicaid plan, ranging from zero to a few dollars per prescription.
  • Over-the-counter items are generally not covered by Medicaid at any pharmacy, including Walgreens, unless they are prescribed by a doctor and meet specific program rules.
  • If Walgreens is out of network for your plan, you can still fill prescriptions there but will pay the full price out of pocket unless your plan allows out-of-network coverage.
  • Some Medicaid managed care plans have restricted pharmacy networks, so calling your plan before your first visit to Walgreens prevents payment problems at the register.

What Medicaid Covers at Walgreens

Medicaid covers prescription medications at Walgreens when the drug is on your state's Medicaid formulary—the official list of covered medications. Your copay depends on the drug's tier (generic, brand-name, or specialty) and your specific plan. Most states charge between zero and five dollars per prescription, though some specialty drugs cost more.

Medicaid does not cover over-the-counter items like pain relievers, cold medicine, vitamins, or first-aid supplies at Walgreens or any other pharmacy. The only exception is if a doctor writes a prescription for an over-the-counter item and your state's Medicaid program covers it as a prescribed medication. This is rare and depends entirely on your state's rules.

Walgreens also offers Medicaid-covered services beyond prescriptions at some locations, including immunizations, health screenings, and medication therapy management. Ask the pharmacy staff whether these services are available at your local store and whether they're covered under your plan.

How to Confirm Walgreens Is In Your Network

The fastest way to confirm Walgreens accepts your Medicaid plan is to call your plan's customer service number, which is on your Medicaid card. Tell them you want to fill a prescription at Walgreens and ask whether that specific store location is in network. They can also tell you your copay amount for different types of drugs.

Alternatively, log into your Medicaid plan's website or mobile app and use the pharmacy locator tool. Enter your zip code or the Walgreens address, and the system will show you whether it's in network and what your copay will be. Some state Medicaid programs also maintain searchable pharmacy directories on their main websites.

If you're on a managed Medicaid plan (not traditional fee-for-service Medicaid), the plan's pharmacy network may be smaller than the state's overall network. In that case, only the plan's website or customer service line will show you accurate information about which Walgreens locations you can use.

What Happens If Walgreens Is Out of Network

If Walgreens is not in your plan's network, you can still fill your prescription there, but you will pay the full retail price out of pocket at the time of purchase. Medicaid will not reimburse you later. The only exception is if your plan allows out-of-network pharmacy coverage, which is uncommon and usually only applies in emergencies or when no in-network pharmacy is reasonably available.

Before paying out of pocket, ask the Walgreens pharmacist whether they can contact your plan to request an exception or prior authorization. Some plans will cover an out-of-network fill if the medication is urgent or if the in-network pharmacy is temporarily closed. This is not may provide, but it's worth asking.

If you regularly need to use an out-of-network pharmacy, contact your Medicaid plan about switching to a plan with a larger network or ask whether you can request a permanent exception for that location.

Medicaid Copays and Deductibles at Walgreens

Medicaid copays at Walgreens are set by your state and your specific plan, not by Walgreens itself. Most state Medicaid programs charge between zero and five dollars per prescription, with generic drugs typically costing less than brand-name drugs. Some plans charge nothing for prescriptions at all.

Medicaid does not use deductibles the way commercial insurance does. You pay your copay at the pharmacy counter when you pick up each prescription, and there is no annual deductible you have to meet first. However, some state Medicaid programs do have annual limits on the number of prescriptions covered, which varies by state.

If your copay seems higher than expected, ask the pharmacist to verify the amount with your plan. Errors happen, and the pharmacist can often resolve them on the spot by contacting your plan's pharmacy support line.

Transferring Prescriptions to Walgreens

You can transfer a prescription to Walgreens from another pharmacy by asking your current pharmacy to send it electronically or by having your doctor send it directly to Walgreens. You can also walk into any Walgreens with your prescription bottle or a paper prescription from your doctor and ask them to fill it.

When you transfer a prescription, tell the Walgreens pharmacist that you have Medicaid and provide your Medicaid card. They will verify your coverage and tell you the copay before they fill it. If the medication is not on your state's formulary, the pharmacist can contact your doctor to request a substitute or ask your plan for prior authorization.

If you're switching to Walgreens because your previous pharmacy was out of network, keep in mind that Walgreens may not have your prescription history on file. Bring a list of all medications you're currently taking so the pharmacist can check for drug interactions.

Frequently Asked Questions

Do I need to show my Medicaid card every time I fill a prescription at Walgreens?

Yes. Bring your Medicaid card every time you visit Walgreens to fill a prescription. The pharmacy staff will scan or manually enter your member ID to verify your coverage and determine your copay. If your card is lost or expired, contact your Medicaid plan immediately to get a replacement or temporary ID number.

What if my prescription is rejected at Walgreens because it's not on the formulary?

Ask the Walgreens pharmacist to contact your doctor and request a formulary exception or a substitute medication that is covered. Your doctor can also call your Medicaid plan to request prior authorization for the non-formulary drug. This process usually takes one to three business days, though urgent requests may be faster.

Can I use my Medicaid at Walgreens to buy things other than prescriptions?

No. Medicaid only covers prescription medications at Walgreens. Over-the-counter items, health and beauty products, and general merchandise are not covered. Some Walgreens locations have clinics that offer Medicaid-covered services like flu shots or blood pressure checks, but you must ask whether these are available at your store.

What if I don't have my Medicaid card with me when I go to Walgreens?

Tell the pharmacist your name and date of birth, and they can look up your Medicaid information in their system if you're in their records. However, it's faster and safer to bring your card. If you've never filled a prescription at that Walgreens before, you may need to provide additional information or come back with your card.

Does Walgreens accept all state Medicaid programs?

Walgreens accepts most state Medicaid programs, but not every Walgreens location participates in every state's program. A store in one state may accept that state's Medicaid but not another state's. Always verify with your specific plan before you go, especially if you're traveling or moving to a new state.