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.
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The pharmacy network includes large national chains; many local, community pharmacies; and, for CO members, the OptumRx Mail Service Pharmacy.
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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.
The Drug Pricing tool can help you compare prices for specific drugs at pharmacies available to you.
You may use insurance in combination with manufacturer coupons when filling a prescription. Only the amount paid out of pocket will be credited toward your deductible and/or coinsurance out-of-pocket maximum. If the coupon pays for the entire cost of the drug, you will have nothing applied toward your deductible and/or coinsurance out-of-pocket maximum.
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.
Click here to view the Golden Rule Advantage 4-tier Prescription Drug List – Effective July 1, 2019
Click here to view the Golden Rule Advantage 4-tier Prescription Drug List – Effective January 1, 2020
Click here to view the Golden Rule Essential 4-tier Prescription Drug List – Effective July 1, 2019
Click here to view the Golden Rule Essential 4-tier Prescription Drug List – Effective January 1, 2020
If you are a shopper seeking Short Term coverage and are considering the Generic $20 Copay option (not available in all states) on the Short Term Medical Plus, Short Term Medical Plus Elite, Short Term Medical Copay, or Short Term Medical Copay Value:
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.
Please call Customer Service at 1-800-657-8205.
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.