Medicare “Preferred Pharmacy” Drug Plans Fail Rural America

By Kevin Schweers

While Medicare officials unfortunately put aside for now their proposal to allow “any willing pharmacy” to serve as a “preferred pharmacy” in Medicare Part D drug plans, the shortcomings of these plans continue to be readily apparent.


To examine beneficiaries’ access to “preferred” pharmacies in rural communities NCPA staff recently logged on to Medicare’s official Plan Finder Web site. We examined Oregon, the home state of new Senate Finance Committee Chair Ron Wyden (D-Ore.).

In Florence, Ore. (population: 8,466) Medicare beneficiaries living in the 97439 zip code live within one mile of five different pharmacies, on average. These seniors have seven pharmacies within 28 miles and 11 pharmacies within 39 miles. However none of them are “preferred” pharmacies in either the Humana Enhanced or Humana Preferred Rx drug plans. To reach one and access the lowest advertised co-pays, these beneficiaries must travel more than 40 miles to reach a preferred pharmacy.

In smaller Rockaway Beach, Ore. (population: 1,312) there is a similar problem for Medicare beneficiaries living in the 97136 zip code. They have one pharmacy within five miles and six pharmacies within 27 miles. But these seniors must travel 38 miles to reach a “preferred” pharmacy in the Humana Enhanced plan and 46 miles to access one in the Humana Preferred Rx Plan.

NCPA included this analysis as part of its recent comments to the Centers for Medicare & Medicaid Services (CMS) in response to the agency’s “call letter” for 2015 Part D drug plans, and will continue advocating for greater patient choice in exclusive “preferred” pharmacy plans.

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