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For all things pharmacy, turn to OptumRx

UnitedHealthcare plans use OptumRx® 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 Medication Program

UnitedHealthcare is taking an important step in its continued efforts to make prescription drugs more affordable by eliminating out-of-pocket costs for drugs that are critical to maintaining the health of our members.

UnitedHealthcare’s Vital Medication Program offers the preferred drugs listed below at no out-of-pocket cost to you:
  • 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.

Please call us at 888-297-0878 for more information on Prescription Drug cost and coverage.

See if your medication is covered:

Search the Prescription Drug List effective May 1, 2024 Opens in a new tab

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) (PDF) > Your doctor needs to provide more information for us to decide coverage.

Step Therapy (ST) (PDF) > 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. covered:

Learn more by visiting Optum Specialty Pharmacy Opens in a new tab

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.

Search for a network pharmacy near you Opens in a new tab

Use home delivery

OptumRx® 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

  • How can I save on medications?

  • Could the tier assigned to my medication change?

  • Will my specialty medication automatically transfer to the specialty pharmacy offered with this plan?

Please note: The above questions and answers are a general description of coverage benefits. You should consult with your official plan documents.

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. 

here 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.