Objective: The efficacy of angiotensin converting-enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta-blockers (BB), aldosterone antagonists (AA), digoxin (DG), and diuretics (DU) in reducing morbidity and mortality among persons with heart failure (HF) has been well established in clinical trials. Using the 2002 Medicare Current Beneficiary Survey, we determined utilization of these drugs in the real-world setting among community-dwelling older adults with HF. Methods: Community-dwelling, non-hospice beneficiaries >65 years of age with a diagnosis code for HF (428.xx) were included. Medication use was determined by beneficiary self-report, documentation of prescription fills, and computer-assisted personal interviews. Diagnosis codes were used to identify beneficiaries without medical contraindications for each drug, who were eligible to receive them. We further classified beneficiaries into groups based on concomitant use of more than one drug: ACEI or ARB and BB (group 1); ACEI or ARB, BB, and AA (group 2); and ACEI or ARB, BB, AA, DG, and DU (group 3). Results: We estimated that 1038, 590, 821, 1059, and 926 survey respondents were eligible to use an ACEI or ARB, BB, AA, DG, or DU, respectively. Among those eligible, 55.9%, 44.1%, 6.7%, 27.6%, and 65.2%, respectively, used at least one drug in the specified class at some time during the study year. For multiple concomitant drug use, 27.2%, 2.5%, and <1% of respondents were in groups 1, 2, and 3, respectively. Conclusion: This retrospective analysis of data from the Medicare Current Beneficiary Survey from 2002, prior to implementation of the Medicare Part D drug benefit, demonstrates that a significant proportion of community-dwelling older adults with HF are not taking appropriate medications for HF. Further pharmacoepidemiological studies are needed to identify areas for improvement within health care. Future analyses should also examine the effectiveness of prescription drug use for Medicare beneficiaries with HF.