On Amazon’s third-quarter 2026 earnings call, CEO Andy Jassy made room for the company’s pharmacy. The number of customers using it is “up over 60% year-over-year,” he said, and Amazon is “now offering three-hour prescription delivery in more than 350 cities,” according to the call transcript.
For people on Medicare, delivery speed has little to do with what a refill costs. The price at the counter, or on the doorstep, depends largely on how your Part D or Medicare Advantage drug plan treats the pharmacy that fills it.
Those pharmacy rules can change from year to year, and Medicare open enrollment runs through Dec. 7, with changes taking effect Jan. 1.
Five checks can show whether a new pharmacy, online or down the street, would save you money or cost you more.
1. Confirm the pharmacy is in your plan’s network
Medicare drug plans contract with in-network pharmacies that agree to discounted prices for members. Some plans cover drugs only when you fill them at one of those pharmacies.
Out-of-network pharmacies usually charge more, and you will likely pay full price. You may be able to request a partial refund by sending receipts to your plan, but it will not cover the out-of-network cost-sharing amount.
2. Look for the word ‘preferred’
Being in network is only the first step. Some plans also designate preferred pharmacies, where copayments or coinsurance may be lower than at a standard in-network pharmacy.
The same generic can carry two different copays at two in-network pharmacies a few blocks apart. Your plan’s pharmacy directory shows which category each one falls into, and that list may change for 2027.
3. Price a 3-month mail-order supply
Some drug plans offer mail-order programs that send up to a three-month supply of covered drugs to your home, and some also offer automatic refills, according to Medicare. For a medication you take every day, the 90-day price through the plan’s mail-order pharmacy may beat three separate 30-day fills.
Jassy said J.D. Power ranked Amazon Pharmacy the top mail-order pharmacy for the third year in a row. Rankings measure customer satisfaction, though, not what your plan charges you there, so compare the copay before switching.
4. Run your pharmacies through Medicare’s plan finder
Medicare’s plan finder lets you enter your prescriptions and the pharmacies you use, including a mail-order option, then estimates your yearly costs under each plan.
Run it twice: once with your usual pharmacy and once with the alternative you are considering. Part D premiums are rising for 2027, so the cheapest premium may not be the cheapest plan once you factor in pharmacy costs.
5. Know what a cash subscription does and does not do
Amazon also sells RxPass, a $5-a-month add-on for Prime members that covers more than 50 commonly prescribed generic medications. Amazon says Medicare beneficiaries can use it and that the service operates independently from health insurance.
That independence cuts both ways. A flat cash price can beat a copay on some generics, but purchases made outside your plan may not count toward your deductible or yearly out-of-pocket limit. Ask your plan before moving a prescription out of its coverage.
Before you decide, compare a pharmacy’s cash price with your insurance copay.
Fast is a bonus, not a discount
A three-hour delivery window is convenient, especially for anyone who has trouble getting to a store. Any savings come from the plan you pick and the pharmacy you pair it with.
You can change that pairing only during limited windows, and open enrollment is the main one for most people. Missing the Dec. 7 deadline generally locks in your current plan for 2027, unless you qualify for one of the other Medicare enrollment windows.