Prescription Plan
All medical plan participants have prescription drug coverage based on their selected plan. A way to save money is by requesting generics and/or mail order options when available.
The prescription drug coverage in the Enhanced and Standard PPO plans has a separate prescription out-of-pocket (OOP) maximum.
Prescriptions on the high deductible health plan are subject to deductible and co-insurance. There are not co-pays on that plan, which means until you’ve met the annual deductible you’ll have to pay the full network discounted amount of that drug. Please review the full cost of any prescriptions you currently take on the UHC member portal so that you understand your costs prior to meeting the deductible.
Your out of pocket costs for prescription drugs will vary depending on which medical plan you select. But the list of covered and excluded drugs is the same on all 4 plans.
OptumRx Prescriptions
Set up your online account
Once registered on myuhc.com, access the pharmacy section to:
- Manage your home delivery medications
- Set up email or text message reminders
- Check your order status
Use the UnitedHealthcare app
Manage your prescription benefits and home delivery orders with the UnitedHealthcare app on your smartphone or tablet.
Use a network pharmacy
Be sure to fill your prescriptions at a network pharmacy, otherwise they may not be covered or you may pay more. Finding a network pharmacy is easy:
- Log in to myuhc.com
- Or use the United Healthcare app
- Or call the number on your health plan ID card
Making medication decisions
Use the UnitedHealthcare prescription drug list (PDL)
The PDL is a list of your plan’s covered medications. The medications are organized into cost tiers. Choosing medications in lower tiers may save you money.
| Cost Tier | Includes | Helpful Tips |
|---|---|---|
Tier 1 – Lowest cost |
Lower-cost medications. Some brand-name medications. | In most cases, Tier 1 medications have the lowest cost. Consider generic options which may also help you save. |
| $$ Tier 2 – Mid-range cost |
Mix of brand-name and generic medications. | Tier 2 drugs may cost less than Tier 3 drugs. |
| $$$ Tier 3 – Highest cost* |
Highest-cost brand-name medications and some generic medications. | Many Tier 3 medications have lower-cost options in Tiers 1 or 2. Ask your doctor if they could work for you. |
*High-cost specialty medications fall into Tier 4.
Save Money
In most cases, generic medications have a lower copay than brand-name medications. Ask your doctor if there is a generic alternative for you.
Compare Prices
Search for lower-cost alternatives. Just log in to myuhc.com. Or use the UnitedHealthcare app.
Video: Prescription Drug Benefits
