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Pharmacies and Pharmacy Access Guidelines

Optima Medicare HMO members have access to a large network of over 1,500 quality pharmacies.

Our Provider and Pharmacy Directory*1 includes information on:

• Retail chain pharmacies
• Our mail order pharmacy vendor, OptumRx
• Other Pharmacies (independent retail, long-term care, and home infusion pharmacies)

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.

You can search our pharmacy network using our convenient online pharmacy locator under "Search Online." This locator allows you to search for pharmacies close to your specific home address, in your city, or by pharmacy name. Maps and driving directions are provided with your results to help you quickly find the most convenient pharmacy for you.

All network pharmacies may not be listed in the directory. If you have any questions about Optima Medicare pharmacies or benefits, please contact us.

*1: To locate a specific pharmacy type, please refer to the printable version of the directory.

Pharmacy Access Guidelines

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

• 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.