Torrington Has Two Pharmacies. That Changes the Medicare Question.

Two pharmacies, two streets

Torrington has Vandel Drug at 2041 Main Street, 307-532-2214. It also has Community Drug at 900 West Valley Road, 307-532-3060.

We should say plainly that Vandel is part of our own group and Community Drug is not. We are naming both anyway, because the point of this post is a decision you are going to make yourself, and you cannot make it on half the information.

Two pharmacies in one town does not sound like much of an advantage. In Goshen County it is one.

What Lusk and Guernsey do not have

Drive north and west and the picture changes fast. In Lusk, Rawhide Drug on South Main is the only operating pharmacy in Niobrara County's county seat. In Guernsey, Register Cliff Pharmacy on West Whalen Avenue is the only pharmacy in town.

In a town with one pharmacy, a Medicare drug plan that treats that pharmacy poorly leaves you with two options: drive, or use mail order. That is the whole negotiation.

Torrington is not in that position, and it changes what you should do about it. You are not stuck with whatever your plan decided about one building. You have a second address in the same town, and — this is the part that goes unmentioned — those two addresses may sit in completely different positions under the exact same plan.

The same plan can treat them differently

Part D is the part of Medicare that covers prescriptions you pick up yourself, whether you buy it as a standalone plan or take it as part of a Medicare Advantage plan. Either way it comes with a pharmacy network, and inside that network plans generally sort pharmacies into two positions.

Medicare describes in-network pharmacies as ones that "have agreed to offer a discounted price for members of certain Medicare plans." A preferred pharmacy is one the plan has a closer arrangement with; in Medicare's own words, preferred in-network pharmacies "have agreed to charge less than other pharmacies in your plan's network." A standard network pharmacy is covered too, but your share is generally higher. There is also out of network, where, in Medicare's wording, you will "probably have to pay full cost for the drugs."

A word about the words, because you will meet both versions. Plan documents commonly say standard for a network pharmacy that is not preferred. Medicare's own site never uses that word — its terms are "preferred in-network" and "other pharmacies in your plan's network." Same distinction, two vocabularies. Knowing both keeps you from losing an argument over terms that do not matter.

Nothing requires a plan to put every pharmacy in a town in the same position. Networks get built contract by contract. So under Plan A, Vandel might be preferred and Community standard. Under Plan B it could be the reverse. Under Plan C one of them might not be in the network at all.

Nobody is going to volunteer this. A plan's pharmacy finder will show you both pharmacies with a green checkmark and consider its job done. The tier is in the plan's own documents, and it is a specific question you have to ask specifically.

Goshen County, in numbers worth knowing

About 18.9% of the United States is 65 or older. Goshen County is 27.0%, out of a population of roughly 12,640.

Wyoming as a whole is 68.9% nonmetropolitan — around 401,360 people living outside a metro area. Colorado, by comparison, is 12.2% nonmetro. Goshen County is not an outlier in Wyoming; it is Wyoming.

That combination — a quarter of the county on Medicare and a state where the next option is usually far — is why a network tier that would be trivia in Cheyenne is worth an afternoon here.

What is in town, and what that means

Community Hospital in Torrington is a Critical Access Hospital, a federal designation Medicare created for small rural hospitals. It requires, among other things, that the hospital actually be rural. Torrington has one. Guernsey does not — it has a clinic, and the nearest hospital is in Wheatland. Lusk has a Critical Access Hospital and a rural health clinic.

Having a hospital and two pharmacies in the same town puts Torrington in a stronger position than most of Goshen County. It also means the people driving in from the ranches and smaller communities around the county are making that trip to reach what you can reach on foot — which is worth remembering when a plan's paperwork treats a long drive as nothing.

How to check it yourself, in about twenty minutes

You do not need anybody's help for this. You need your medication list and the plan's own materials.

1. Write down every prescription you take, with the strength and how often. Not from memory — off the bottles. This is the single step people skip and the single step everything else depends on.
2. Find the plan's pharmacy directory, not its map tool. The directory is the document that states tiers. If you cannot find it, call the plan and ask for the pharmacy directory for Goshen County, Wyoming, by name.
3. Look up both addresses. 2041 Main Street and 900 West Valley Road. Ask whether each one is preferred, standard, or out of network. Get an answer for both, not one.
4. Ask the same question about a 90-day fill. Medicare notes that some pharmacies may offer a 2- or 3-month supply of covered drugs, and that mail order can run up to a 3-month supply. Those are not necessarily priced the same. If your winter driving is limited, this is the question that matters most.
5. Check your drugs against the plan's formulary — the list of what it covers and at what tier. A plan can put your pharmacy in the preferred tier and still move one of your drugs to a tier that costs more, or add a rule requiring approval first.

Then take the answers to whichever pharmacy you use and ask the pharmacist whether the picture matches what they see. They fill these prescriptions under these plans every day, and they will know immediately if something looks off.

The free counseling nobody mentions

Wyoming runs the Wyoming State Health Insurance Information Program — WSHIIP — with counselors trained on Medicare who do not sell plans and do not work for one.

1-800-856-4398.

There is no catch and no cost. It exists precisely so that a person can get a Medicare question answered without being sold something at the end of it. Most people who are entitled to it have never been told it exists.

If you deal with Colorado or Nebraska too, the equivalents are 888-696-7213 for Colorado and 1-800-234-7119 for Nebraska.

On veterans, briefly, and honestly

Goshen, Niobrara and Platte counties have a high share of veterans, and how VA pharmacy benefits coordinate with a Medicare drug plan is a real question with real answers. It is also a question where the details matter exactly, and getting one of them approximately right is worse than not writing it.

So we are not going to summarize it here from memory. We are writing that post separately, with the rules checked against the VA's and Medicare's own published material, and it will name the facilities that serve this corner of Wyoming. If that is your situation and you would rather not wait, WSHIIP counselors handle this specific coordination question routinely.

Where we come into this

Haven Health Plans was started by the pharmacists at Good Day Pharmacy. Good Day operates a network of local community pharmacies across Colorado, Wyoming and Nebraska, and Vandel Drug in Torrington is one of them.

Which means the obvious suspicion needs answering before you have to ask it.

We do not pick plans around pharmacies. What a plan recommendation rests on is your medication list, your doctors and your budget. Your pharmacy enters the conversation when you say you want to keep it — and if the plan that works best for your list happens to treat Community Drug better than it treats Vandel, then that is what we will tell you, and you should hold us to it.

The reason a pharmacist is useful in this conversation is not loyalty. It is that we read a medication list the way a pharmacist reads one, which is a different thing from reading it as a set of line items to be priced.

And the standing rule, in this post and every other: do not stop, skip or reduce a medication on your own over a cost question. Take it to the person who prescribed it. If cost is the real problem, say so directly to both the prescriber and the pharmacist — there are usually more moves available than people expect, and none of the good ones involve stretching a prescription.