Pharmacy Services

Get Smart About Prescriptions

Our online tools make it easy

Starting May 1, 2023, you can access:

optum Rx

My prescriptions

See your current prescriptions along with information about how to use them and possible side effects.

Price a drug

Search your current or new medications to see costs at pharmacies near you. If you’re taking a brand-name drug, you can also see prices for generic options.

View my claims

See which prescriptions you’ve filled and how much you paid.

Pharmacy locator

Search for network and on-site pharmacies near you — or find a pharmacy when you’re traveling.

Getting Started

Visit optumrx.com or call (866) 339-3731 to register your account. You’ll need information from your new member ID card to sign up. Then, after May 1, 2023, access your account details and prescriptions.

 

Get the app.

Download the Optum Rx app to manage your medications on the go.

To learn more now about Optum Rx and your drug plan, Scan this code

Skip the pharmacy. We deliver to you.

If you take a medication regularly, you could save time and
money with Optum Home Delivery after May 1, 2023.

  • Order up to a 3-month supply.
  • Get your medications delivered right to your mailbox — with free standard shipping.
  • Talk to a pharmacist 24/7

Submit your order one of three ways:

Online at optumrx.com

Via the Optum Rx app

Call the phone number on your member ID card

Will my current prescriptions transfer?

Yes, most will transfer to Optum Home Delivery. But prescriptions for some medications such as controlled substances will not transfer. In these cases, you’ll need a new prescription from your doctor.

Prior Authorization

What is a prior authorization?

Prior authorization (PA) requires your doctor to tell us why you are taking a medication to determine if it will be covered under your pharmacy benefit. Some medications must be reviewed because they may:

  • Only be approved or effective for safely treating specific conditions
  • Cost more than other medications used to treat the same or similar conditions

How can I find out if my medication requires PA?

At the pharmacy

When you fill a new prescription, your pharmacist will tell you if a PA is required.

Online

Look online to see if your medication has a PA.

  • Log into optumrx.com > Member tools
  • Click on Drug pricing and information
  • Enter the drug name and dose
  • If the drug/dose you entered needs a prior authorization, you will see an alert below the drug name.

Coverage alert This drug requires a prior authorization from your provider. Please contact your provider to complete. If the prior authorization is approved, the actual price you pay may be different than the price listed.

On the phone

Call Optum Rx at the toll-free phone number on your member ID card.

What do I do if my medication needs a PA?

To begin the PA process, you can:

  • Let your doctor know that a PA is needed for your medication.
  • Call Optum Rx at the toll-free number on your member ID card.

How long does it take for a PA to be approved or denied?

Once your PA has been submitted and received, it usually takes up to 24 hours to process. If your PA request needs additional review, it may take longer. If your doctor submits a PA request electronically, they may receive approval within minutes of submitting the request.

How do I know if my medication has been approved for coverage?

Once we review the information from your doctor, we will send a letter to you and your doctor letting you know if your medication coverage is approved or denied.

  • Check the status of your PA by signing into optumrx.com > Benefits and claims > Prior authorization or exception request. You will see the status of any active PAs in process.
  • If your medication is approved, the PA is entered and coverage will be provided under your benefit. You can continue to fill your prescription at the pharmacy as usual during the approved PA period. Depending on your benefit plan and medication, you may be able to save money by using home delivery from Optum.
  • If your medication is denied, we’ll send a letter telling you why and provide information about the appeal process.

Why is Optum Rx questioning my doctor’s choice of medication for me?

We want to make sure that coverage and costs align with the effectiveness of the medication you have been prescribed. If your medication needs a PA, that means we need more information from your doctor before deciding if your plan should cover the medication. If we don’t get this information from your doctor or your PA is not approved, we may not cover the medication.