Prescription drugs can play an important role in your health, whether you need them every day or once in a while. Knowing how your benefits work may help you fill your prescriptions more easily and help manage costs. Let’s walk through how to use your pharmacy and prescription drug benefits.
Use your mobile device to get instant access to see your prescriptions, find pharmacies and more.
Download the UnitedHealthcare app to get instant access to see your prescriptions, find pharmacies and more.
Use these resources to view general pharmacy locations and drug coverage details. Make sure to confirm your plan’s specific coverage details before filling a prescription.
Your prescription drug benefit includes a list of medications covered by your plan. This list is called a Prescription Drug List (PDL). You may also see it called a formulary or drug list. When your doctor prescribes a medication, check your PDL to see if it’s covered.
If a prescribed medication is in a higher cost tier, ask your doctor if a lower cost option will work for you. A similar drug or generic version can often work just as well.
Some medications need prior authorization. This means your doctor must explain why you need the drug. Then your plan decides how or if they will cover it. To start the prior authorization process, call the number on your member ID card.
Keep in mind that PDLs may change. If you have prescriptions you take regularly, watch for notifications about PDL updates and possible cost changes.
If you’re a UnitedHealthcare member, there are pharmacy programs that may be available to help you save on costs.
Are you an Oxford or Affordable Care Act (ACA) Marketplace plan member? View pharmacy benefit information for UnitedHealthcare Individual & Family ACA Marketplace plans and Oxford plans.
Visit the Optum Store and shop for nonprescription medications, everyday essentials and more.
With some plans, you can fill your prescriptions at a participating network pharmacy or with home delivery.
Choosing a network pharmacy may help you save on medication costs. Sign in to your member account to view a list of pharmacies included in your plan’s network.
Plans that include home delivery help you avoid regular trips to the pharmacy and may save you money. You can enroll through your online account or by calling the number on your member ID card.
You may see the name Optum Rx on your prescription benefits. This is the UnitedHealthcare pharmacy service provider. Optum Rx offers coverage through a large network of retail chain pharmacies and independent pharmacies. It also offers coverage through its mail order pharmacy, Optum Home Delivery®.
You can Sign in to your member account to view your prescription benefit details. Members can also view plan details with the UnitedHealthcare app.
Many plans may offer cost savings if you fill your prescriptions at a pharmacy within the plan's preferred network. Sign in to your member account to view your plan’s preferred network pharmacies.
If your prescription drug benefit includes home delivery, you can choose to have medications delivered by mail through Optum Home Delivery. You may be able to order up to a 3-month supply of medication you regularly take — and there’s usually no charge for standard shipping within the U.S. Sign in to your member account to enroll or call the number on your member ID card.
Members can compare medication prices in the UnitedHealthcare app. You can download the app now if you don’t already have it.
Medications used to treat complex or rare conditions, such as cancer, hepatitis C and multiple sclerosis, are called specialty medications. You may need to get these medications filled at a specialty pharmacy, which provides educational and clinical support for these types of medications. Visit the Optum Specialty Pharmacy or call the number on your member ID card to find a specialty pharmacy for your medication.