Golden Rule Insurance Company - Prescription Benefits

Pharmacist and Pharmacy Benfits

UnitedHealthcare wants you to get the most out of your pharmacy benefit. You have benefit coverage for a wide variety of U.S. Food and Drug Administration (FDA)-approved prescription medications.

Find a Network Pharmacy
The pharmacy network includes large national chains; many local, community pharmacies; and, for CO members, the OptumRx Mail Service Pharmacy.

 Click to find a retail network pharmacy in the National Network if you are:

  • A shopper seeking Short Term coverage
  • An existing ACA plan member seeking a retail pharmacy in 2016
  • An existing ACA plan member seeking a retail pharmacy in 2017 (except members in CO, DE, NV; and members in VA with a Bronze Copay Select P or Bronze 100)

    •  Click to find a retail network pharmacy in the Value Network if you are:

      • An existing ACA plan member seeking a retail pharmacy in 2017 and live in CO, DE, NV; or in VA with a Bronze Copay Select P or the Bronze 100

      Find Information on Specialty Pharmacy

       Click to find specialty pharmacy information


      Drug Pricing

      We want to help you manage your prescription medication costs and get the most out of your pharmacy benefit. Our programs and tools are designed to help you make informed decisions about your choice of prescription medications.

      If your pharmacy benefit includes a tiered copay plan, please refer to the Prescription Drug List (PDL) to find the tier placement of your drug. Once you’ve identified the tier placement, use your documents to find the copay amount for that tier.

      Prescription Drug List (PDL)

      The UnitedHealthcare PDL includes brand and generic prescription medications approved by the FDA. Medications are placed on different "tiers" based on our evaluation of their overall value. Tier 1 is the lowest-cost tier option. The PDL is a tool to help you look for lower-cost alternatives. When selecting a medication, you and your doctor may wish to consult the PDL. You and your doctor make decisions about your health care, including the choice of prescription medications.


      If you have a current Affordable Care Act (ACA) plan that will be modified in 2017 for all states EXCEPT CT:

       Click here to view the Golden Rule Essential 4-tier Prescription Drug List – Effective January 2017 through June 2017


      If you have a current Affordable Care Act (ACA) plan that will be modified in 2017 for CT:

       Click here to view the Golden Rule Advantage 4-tier Prescription Drug List – Effective January 2017 through June 2017


      If you are a shopper seeking Short Term coverage effective PRIOR to 1/1/17:

       Click here to view the Golden Rule Advantage 4-tier Prescription Drug List


      If you are a shopper seeking Short Term coverage effective AFTER 1/1/17:

       Click here to view the Golden Rule Generic Only Prescription Drug List


      The formulary lookup tool provides the brand name, generic name, dosage form and tier status. It does not take into account any cost that your plan pays. It is not specific to your benefit and is not available for all medications. The information is for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. Note: This is only a guide. Tier structure for your Rx coverage will depend on your exact plan and will be subject to all plan provisions.

       Click here to look up a medication on the Essential PDL

       Click here to look up a medication on the Advantage PDL

       Click here to look up a medication on the Traditional PDL (COMING SOON!)

      Note: When a Prescription Drug Product is excluded from coverage, you and your representative may request an exception to gain access to the excluded Prescription Drug Product. To make a request, contact us in writing or call the toll-free number on your ID card. We will notify you of our determination within 72 hours.

Contact Us

Application Support:

Please call Customer Service at 1-800-657-8205.

Member Support:

Please call the Customer Service number listed on the back of your ID card (if you are currently a member).

If you are experiencing a medical emergency, call 911.

UHONELGLRXGRICR3