In-network Pharmacies

To find an in-network pharmacy, follow this link.

Rates and Coverage

Please refer to the Benefits Guide for information on the rates and a summary of coverage.

Plan Information

For a more detailed explanation of this benefit, please review this summary from OptumRx.

Click to read the Prescription Formulary and Premium Formulary Exclusions effective January 1st through December 31st. If a medication you take is impacted by the formulary update, you will be notified by mail prior to the change. You can access the most up-to-date information by visiting www.optumrx.com.

Preventive Care Medications

Under the Affordable Care Act, benefit plans must cover certain Preventive Care Medications at 100%. Click here to view the list of preventive medications and products available to you at no cost. You can use your OptumRx member ID card to get the products on this list for no cost if they are: prescribed by a health care professional, age and condition appropriate, and filled at a network pharmacy.

Specialty Medications

Most drugs are “traditional medications.” A few drugs are considered “specialty” medications. Specialty medications covered under the pharmacy benefit will be subject to a coinsurance and maximum on Option 2/Option P and 3.

	Option 1	Option 2/Option P	Option 3
Value Medication*	Deductible, then 20% up to the Out-of-Pocket Maximum	8% Coinsurance with a $100 Maximum/Rx
Preferred Medication*		15% Coinsurance with a $200 Maximum/Rx
Non-Preferred Medication*		25% Coinsurance with a $300 Maximum/Rx

 *Call the customer service number on the back of your OptumRx card to find out whether you are taking a value, preferred or non-preferred specialty medication. Ask your doctor and pharmacist about whether there are traditional medications or value specialty medications that you can try.