Pharmacy Access Guidelines

In keeping with Centers for Medicare and Medicaid Services (CMS) guidelines, our pharmacy network meets the following:

  • Optima Medicare HMO has over 1,500 pharmacies in the network;
  • At least 90% of Medicare beneficiaries, on average, in urban areas live within two miles of a network pharmacy;
  • At least 90% of Medicare beneficiaries, on average, in suburban areas live within five miles of a network pharmacy;
  • At least 70% of Medicare beneficiaries, on average, in rural areas live within 15 miles of a network pharmacy.

The inclusion of a pharmacy in the directory does not guarantee that the pharmacy is open or is at the same location as listed in the directory. Listing does not guarantee participation in the network.

All network pharmacies may not be listed in the directory.

If you have any questions about Optima Medicare pharmacy benefits, please contact us.