Pharmacy Benefits

Prescription Drug Coverage for Medical Plans

Each medical plan option includes coverage for prescription drugs, outlined below, managed by Optum Rx. Optum Rx has a network of 67,000 pharmacies, including CVS, Walgreens, Walmart, Sam’s, Kroger, and more. If you have questions, call Optum Rx at 844-785-1599 or visit www.optumrx.com.


Maintenance Medications with Optum Rx

Maintenance medications are those you take on a regular basis (high blood pressure, diabetes, birth control, etc.). New prescriptions will initially have one 30-day grace fill available, then you will transition to a 90-day supply through a retail pharmacy or home delivery.

Download the Optum Rx App

Make your online pharmacy experience as easy as possible. Through the OptumRx app, you can:

  • Access ID cards
  • Search drug prices and formularies
  • Locate a network retail pharmacy
  • Manage medication reminders
  • Transfer, refill, and track home delivery orders

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Home Delivery

Order up to a 90-day supply of the medication you take regularly for less. There’s no charge for standard shipping to U.S. addresses. You can set up home delivery online at www.optumrx.com or call OptumRx at 844-785-1599. Make sure you have your doctor’s contact information, the name and strength of your medications, and payment information handy.

Is My Drug On the Formulary?

A formulary is a list of generic and brand-name drugs that are approved by the Food and Drug Administration (FDA) and are covered under your prescription drug plan. If your drug isn’t on the formulary, you’ll pay more for it. The formulary is the same for all three medical plan options at USACS. For more information on covered drugs, review the formulary list at www.optumrx.com.

Is My Drug Considered “Preventive” (Covered 100%)?

The Affordable Care Act requires that certain preventive care drugs be covered at 100% when you fill them in network. This applies across all plan options. Review the preventive drug list at www.optumrx.com for details.

If your prescription is not considered preventive, the cost will depend on how your medication is classified — either Generic, Preferred, or Non-Preferred. Generics will cost less than Preferred and Non-Preferred drugs. Visit www.optumrx.com to confirm if your prescriptions are covered and find in network pharmacies.

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