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For all things pharmacy, turn to Optum Rx
UnitedHealthcare plans use Optum Rx® for pharmacy care services. We’ve designed it to be easier for you to save on medications and easier to keep track of them, too — whether you’re online or on the go.
UnitedHealthcare's Vital Medications Program
The Vital Medication Program1 offers these select prescription drugs at no additional cost. This means there may be no out-of-pocket cost, copay or deductible on select prescription drugs that may be essential to your health. Select prescription drugs include:
- insulin - rapid, short and long-acting
- epinephrine - allergic reactions
- glucagon - hypoglycemia (low blood sugar)
- naloxone - opioid overuse
- albuterol – asthma
Please call us at 888-297-0878 for more information on Prescription Drug cost and coverage.
See if your medications are covered
Using the Prescription Drug List (PDL) is the easiest way to find out which prescription drugs are covered by a plan. It includes both brand-name and generic prescription drugs approved by the U.S. Food and Drug Administration.
Drug lists can and do change, so its always good to confirm coverage. Please call us at 888-297-0878 for more information on Prescription Drug Cost and Coverage.
See if your medication is covered:
Find preventive medications covered at no cost:
How to use the Prescription Drug List
The Prescription Drug List (PDL) arranges medications into tiers, and each tier is assigned a cost that’s determined by your employer or health plan. Choosing medications from the lower tiers may help you save money.
Tier 1: Lowest cost
Medications that provide the highest overall value — mostly generic and some brand-name medications
Tier 2: Mid-range cost
Medications that provide good overall value — mainly preferred brand-name medications, as well as generic drugs
Tier 3: Highest cost
Medications that provide the lowest overall value
Important
Certain medications may be excluded from coverage or subject to prior authorization. You may need to switch to another option. You will need to take the following actions before your medication will be covered:
Notification or Prior Authorization (N) - Your doctor needs to provide more information for us to decide coverage.
Step Therapy (ST) - A lower-cost medication will need to be tried before a higher-cost medication is covered.
Manage your specialty medications
Specialty medications
Specialty medications are typically high-cost medications used for complex or rare conditions. These medications can be injectable, oral or inhaled and may need ongoing clinical oversight, have unique shipping or storage requirements or are not typically available at retail pharmacies.
Specialty pharmacy program
The Optum® Specialty Pharmacy is available to covered members using a specialty medication. Once you’re a member, you can register to access personalized support.
2 ways to fill your prescriptions
Use a network pharmacy
Our pharmacy network includes thousands of retail pharmacies, including large national chains and many community pharmacies. Using them may cost you less out of pocket. Prescription drug costs may vary by pharmacy.
Use home delivery
Optum Rx® home delivery is a convenient and cost-effective option for medications you take regularly. Order a 3-month supply online, by phone, through the UnitedHealthcare app or by mail.
Answers to questions to help you understand your pharmacy benefits
Please note: The above questions and answers are a general description of coverage benefits. You should consult with your official plan documents.
1Available to eligible members. Check your coverage details at myuhc.com/rx.
Medications are categorized by common therapeutic conditions in this reference guide for ease of reference only. These categories do not determine coverage for the medication for your condition. Your benefit plan determines how these medications may be covered for you.
Where differences are noted between this reference guide and your benefit plan documents, the benefit plan documents will govern.
Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates.
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