After pharmacy chain Rite Aid filed for bankruptcy in May, CVS bought some of its stores, including the Bartell Drugs locations it owned, and patient records across the Pacific Northwest.

For some, the switch has been messy.

Many insurance plans classify pharmacies as either in-network or out-of-network, the same way they do for doctors and medical facilities.

That means some people who have been picking up their medications from their neighborhood pharmacy for years may no longer be able to do so.

“If CVS bought Bartell and Rite Aid stores, they now are owned by CVS,” said Dima Mazen Qato, an associate professor of clinical pharmacy at the University of Southern California. “CVS is probably not the preferred pharmacy for the same plans for which Rite Aid and Bartell were preferred or in-network.”

Whether a pharmacy falls within an individual’s insurance network varies by plan. At out-of-network pharmacies, people generally must pay full price for their medication, meaning they could face bills in the hundreds or even thousands of dollars.

That’s what happened recently to Nicole J., a Shoreline resident whose prescription file moved from Rite Aid to CVS. Nicole asked to be identified by her first name and middle initial to protect her sensitive medical details.

Nicole is on Medicaid, commonly known in Washington as Apple Health, and gets health coverage through the Community Health Plan of Washington. Late last month, she called her new CVS pharmacy for a medication refill. It wasn’t until the prescription was ready for pickup that she learned that CVS isn’t among her plan’s network pharmacies. Out of pocket, she would have had to pay $800 for a month’s supply — a sum she would not have been able to afford.

Her experience is not uncommon. In fact, it happens regularly when pharmacies get bought out or shut down, said Qato.

On social media, Washington residents have complained about long wait times and dead ends when calling to get their records sent from CVS to an in-network pharmacy.

To address potential delays, the state Department of Health in July urged former Rite Aid customers to request refills early so that pharmacies have “ample time” to process them.

CVS acknowledged this week that people might run into issues getting their prescriptions as the pharmacy continues to integrate prescription files from former Rite Aid and Bartell Drugs locations.

“CVS Pharmacy may be excluded from some payer networks in Washington,” wrote Amy Thibault, executive director of corporate communications. “If that's the case, the pharmacy team will work with the patient to transfer their prescriptions to an in-network pharmacy, if requested.”

Delays in prescription refills can be problematic.

“Patients that are dealing with disruptions of pharmacy access — whether it's a closure or basically not being able to go to a pharmacy because it doesn't cover the cost of your drugs — they're less likely to fill or adhere to their medication regimens, which has health implications,” said Qato, who is a senior scholar at the Schaeffer Center for Health Policy and Economics at USC.

Nicole’s issue was compounded by difficulties she had in transferring a controlled drug prescription out of CVS.

Her medication is a Schedule III controlled substance. Under federal drug regulations, patients can only transfer prescriptions for such medications between pharmacies once before they need a new prescription.

Nicole said the pharmacy team at CVS refused to transfer her prescription on the basis that she’d already reached her transfer limit. She believes the pharmacy counted CVS’ acquisition of her file from Rite Aid as a transfer. (A CVS spokesperson wrote in an email that acquisitions of patient files do not count as transfers.)

Ultimately, Nicole reached out to her doctor, who wrote her a new prescription. By the time she finally received her medication, almost a week had lapsed.

“It was just really frustrating,” she said. “You don't want to have interruptions in medication that you're trying to take regularly.”

CVS' takeover comes during a prolonged stretch of difficulty for the pharmacy business. Washington is among the states that has been hardest hit by industrywide closures, which make pharmacies more scarce and difficult for residents to access.

CVS acquired 49 Rite Aid and Bartell Drugs locations in Washington this year, as well as the prescription files from 61 others.