Pharmacy and prescription drug benefits

Prescription drugs can play an important role in your health, whether you need them every day or once in a while. Knowing how your benefits work may help you fill your prescriptions more easily and help manage costs. Let’s walk through how to use your pharmacy and prescription drug benefits.

Sign in to see pharmacy benefits for your plan

Try the UnitedHealthcare app for members

Use your mobile device to get instant access to see your prescriptions, find pharmacies and more.

Looking for a pharmacy or Prescription Drug List (PDL)?

Use these resources to view general pharmacy locations and drug coverage details. Make sure to confirm your plan’s specific coverage details before filling a prescription.

Review your plan’s prescription drug coverage

Your prescription drug benefit includes a list of medications covered by your plan. This list is called a Prescription Drug List (PDL). You may also see it called a formulary or drug list. When your doctor prescribes a medication, check your PDL to see if it’s covered.

Tips for using your pharmacy benefit

Ask about lower cost options

If a prescribed medication is in a higher cost tier, ask your doctor if a lower cost option will work for you. A similar drug or generic version can often work just as well.

See if you need prior authorization

Some medications need prior authorization. This means your doctor must explain why you need the drug. Then your plan decides how or if they will cover it. To start the prior authorization process, call the number on your member ID card.

Review your PDL regularly

Keep in mind that PDLs may change. If you have prescriptions you take regularly, watch for notifications about PDL updates and possible cost changes.

Look for ways to save

If you’re a UnitedHealthcare member, there are pharmacy programs that may be available to help you save on costs.

Are you an Oxford or Affordable Care Act (ACA) Marketplace plan member? View pharmacy benefit information for UnitedHealthcare Individual & Family ACA Marketplace plans and Oxford plans.

Want to shop over-the-counter (OTC) products?

Visit the Optum Store and shop for nonprescription medications, everyday essentials and more.

How to fill your prescriptions

With some plans, you can fill your prescriptions at a participating network pharmacy or with home delivery.

Find a network pharmacy

Choosing a network pharmacy may help you save on medication costs. Sign in to your member account to view a list of pharmacies included in your plan’s network.

Set up home delivery

Plans that include home delivery help you avoid regular trips to the pharmacy and may save you money. You can enroll through your online account or by calling the number on your member ID card.

What is Optum Rx?

You may see the name Optum Rx on your prescription benefits. This is the UnitedHealthcare pharmacy service provider. Optum Rx offers coverage through a large network of retail chain pharmacies and independent pharmacies. It also offers coverage through its mail order pharmacy, Optum Home Delivery®.

Frequently asked questions