Your UnitedHealthcare pharmacy benefit provides coverage for the majority of prescription medications approved by the U.S. Food and Drug Administration (FDA). Our goal is to support you and your doctor by providing access to a wide variety of medications and helping to make the medications you need more affordable. We offer programs and tools to help you make informed decisions, save money and get the most out of your pharmacy benefit.
When selecting a medication, you and your doctor should review the appropriate Prescription Drug List (PDL) and Drugs with Special Rules list.
Prescription Drug Lists
Drugs With Special Rules
The PDL includes most brand and generic medications approved by the FDA. Medications may be placed on different “tiers” based on their overall value, with Tier 1 being the most affordable tier option. To determine if a medication is covered by your pharmacy benefit, its tier level and any available lower cost alternatives, view the OptumRx Online Pharmacy.
Health Care Reform Prescription Changes
To comply with the health reform law, UnitedHealthcare is offering:
- A list of prescription contraceptives available to you on Tier 1, or the lowest tier on your Prescription Drug List (PDL), for no cost. These contraceptives are available now for most benefit plans.
- The U.S. Preventive Services Task Force A&B Recommendation medications for no cost at point of sale at network pharmacies starting November 1, 2013. These drugs include aspirin, folic acid supplements for women, iron supplements and prescription fluoride for children, and vitamin D supplements for older adults.
- OTC contraceptives for women at no cost at point of sale at network pharmacies starting November 1, 2013. OTC contraceptives include female condoms, emergency contraceptives, and contraceptive film, foam and gel.
Please see the most commonly used Preventive Care Medications (Advantage) and Preventive Care Medications (Traditional). Although these lists may change over time or be different due to your specific plan design, you can always learn the cost of contraceptives for your plan from the OptumRx Online Pharmacy, or by calling the number on the back of your health ID card.
For more information about Health Care Reform, visit our United for Reform website or healthcare.gov.
Always refer to your benefit plan materials to determine your coverage for medications and cost-share. Some medications listed on the PDL may not be covered under your specific benefit. Where differences are noted, the benefit plan documents will govern.
What if the Federal Health Reform Law requirements for Preventive Care Medications coverage change?
If the law requiring plans to provide Preventive Care Medications at no cost changes, information on how your costs may be impacted will be available to you through this website or by calling the member phone number on the back of your health plan ID card.
You can visit the OptumRx Online Pharmacy to view pharmacy claims, sign up for mail order delivery, and locate an in-network pharmacy.
Need to be reimbursed for your prescription drugs? Use our Prescription Drugs Claim Reimbursement Form.
Not a member yet? Get general pharmacy information from our Sample Online Pharmacy.
If you have questions regarding your pharmacy benefit coverage, call the Customer Care number on your ID card. Representatives are available to assist you 24 hours a day, every day of the year, except Thanksgiving and Christmas.