Optum RX

Mail Order Prescription Drug Information

Mandatory mail order for certain maintenance drugs is required. Employees will pay the full cost of medications after the 3rd fill at a retail pharmacy. Save time and money, enroll today. Visit the OptumRx™ website at www.optumrx.com for a fast, safe and secure way to manage your prescription benefits online.

  • Save time and money when you fill your prescriptions online at our mail service pharmacy.
  • Get up to a 90-day supply of your medicine delivered to your home – with no charge for standard delivery.
  • See what medications are covered by your benefit plan.
  • Search for drug pricing and lower-cost alternatives.
  • View your OptumRx™ benefits in real time.
  • Sign up for medication reminders via text message.
  • OptumRx™ Pharmacists are available 24 hours a day, 7 days a week to answer questions from mail service customers. To reach a pharmacist toll-free, dial (877) 559-2955.

2018 Preventive Medications

Your health is important.  Taking preventive medications as directed by your health care provider can help you avoid serious illness and high health care costs.  Your pharmacy benefit plan includes special coverage for preventive medications.  Drugs on your plan’s list of preventive medications are not subject to a deductible.  Instead, you will pay just a $5 copay or no copay at all for certain drugs.  Click here to view the current Preventive Medical list.

Mandatory Generic Substitution

If generic equivalent is available, you must request the generic drug or pay the difference between generic and brand name costs. This requirement is for ALL prescriptions and not just mail ordered prescriptions. Specialty drugs are priced at $50 copay per prescription.

Employees on the CDHP will pay the cost of their medications up to their deductible amount before the plan will pay according to the schedule below with the exception of the drugs on the Preventive Medication List. The majority of drugs on this list will have a $5 co-pay and are not subject to a deductible.

What about short-term drugs such as antibiotics?

You should continue to purchase short-term drugs from a participating retail pharmacy. You will pay your standard retail co-payment for up to a 34-day supply.

How long does it take to get my medications when I use OptumRx™?

Your medication will usually arrive within 8 days after OptumRx receives your order. Expedited shipping is available for an additional cost.

What is a specialist pharmacist?

Specialist pharmacists are trained to be specialists in the medications used to treat a single long-term condition. As a result, they’re better equipped to answer questions that you may have about your long-term treatments. Using OptumRx™ gives you access to specialist pharmacists.

Specialty Drugs are filled only for one-month supply at a $100 copay per prescription, after deductible is met.  

Generic Drugs

$10

First three purchases of up to a 34-day supply at a participating retail pharmacy, after deductible is met. No coverage after the first three purchases of a long-term medication, employee pays 100%.

$25

Up to 90-day supply through OptumRX Pharmacy, after deductible is met.

 

Preferred Name-Brand Drugs

$30

First three purchases of up to a 34-day supply at a participating retail pharmacy, after deductible is met. No coverage after the first three purchases of a long-term medication, employee pays 100%.

$75

Up to 90-day supply through OptumRX Pharmacy, after deductible is met.

 

Nonpreferred Name-Brand Drugs

$50

First three purchases of up to a 34-day supply at a participating retail pharmacy, after deductible is met. No coverage after the first three purchases of a long-term medication, employee pays 100%.

$125

Up to 90-day supply through OptumRX Pharmacy, after deductible is met.

 

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