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 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:
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.
See if your medication is covered:
Find preventive medications covered at no cost:
The 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.
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.
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.
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.
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 >
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.
Use lower tier medications, such as generics. Ask your doctor or use the PDL. If you use a medication that is in Tier 3 or Tier 2, you can check to see if a lower tier option is available and would work for you. More expensive medications are typically placed in higher tiers.
Use home delivery. Get up to a 3-month supply of your medications shipped to the location of your choice, often at lower cost than retail. You’ll also get 24/7 phone support, medication refill reminders and more.
Use network pharmacies. Get your plan’s best price by using a network pharmacy. Our network includes thousands of pharmacies across the country.
The PDL is updated several times during the year. This means medications may:
No, your specialty medication will not automatically transfer to the Optum Specialty Pharmacy. We can help you move your medications after your coverage starts. When you become a plan member, enroll with Optum Specialty Pharmacy by:
Please note: The above questions and answers are a general description of coverage benefits. You should consult with your official plan documents.