Connecting billions of data points, we empower doctors to make informed decisions. An important part of the pdl is giving you choices so you and your doctor can choose the best course of treatment for you. Welcome to the caterpillar drug formulary this formulary applies to active employees and certain retirees that are covered by the prescription drug benefit provisions of the caterpillar inc. We tackle trends and pinpoint solutions for our clients. Covered generic drugs covered brandname drugs on optumrx formulary. Optumrx pharmacy care services pharmacy benefit management. The optumrx business committee meets monthly to evaluate tier placements and new prescription products approved by the food and drug administration fda. To access the optumrx formulary on the optumrx website, there are two options. This may not be a complete list of medications, and not all medications listed may be covered by your plan.
Look up possible lowercost medication alternatives. The gchp list of covered drugs can assist practitioners in selecting clinically appropriate and cost effective products for their patients. Behind every prescription, more than 150,000 people work. Unitedhealthcare prescription drug lists pdl drug formulary.
Call a customer care representative tollfree at 855 8289834 tty 711. A major goal as a medicare part d contractor is to ensure that our beneficiaries receive safe, highquality, costeffective medication therapy. A formulary is a list of covered drugs optumrx in consultation and a team of healthcare providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Your 2016 formulary optumrx 1 effective july 1, 2016. These changes made periodically throughout the year are reflected below. Call the tollfree member phone number on your health plan id card. Locate a participating retail pharmacy by zip code. Visit your plans member website listed on your id card to. They also make sure there are safe and covered options. At optumrx, we want to help you better understand your medication options. Member belongs to an optumrx pharmacy plan nonmedicare. All other brand or product names are trademarks or registered marks of their respective owners. Briovarx, the optumrx specialty pharmacy, can provide most of your.
Where differences between this formulary and your benefit plan. Locate an optumrx innetwork pharmacy look up possible lowercost medication alternatives compare medication pricing. Please fill out all applicable sections on both pages completely and legibly. Average ingredient cost can have wide variation based on drug mix within a specific population. Select formulary reference guide consolidated health plans. Call briovarx at 18554briova 18554274682 and have your prescriptions delivered. You and your doctor can use the formulary to help you choose the most costeffective prescription medications. However, you can provide access to the medications your patients need to stay healthy, at a cost that is more affordable, when you choose a generic or preferred drug as appropriate. Search your plans formulary register via our mobile website. A formulary identifies the drugs available for certain conditions and organizes them into cost levels, also known as tiers. You and your doctor can use the formulary to help you choose the most costeffective prescription. Optumrx helps deliver pharmacy care services to 250,000 patients each day. Our contact information, along with the date we last updated the formulary, appears on the cover. These brandname medications have been identified as having available generic equivalents covered at tier 1 on the formulary.
Your 2016 formulary signaturevalue threetier effective january 1, 2016 please read. Your 2016 prescription drug list effective july 1, 2016 please read. Formulary a formulary identifies the drugs available for certain conditions and organizes them into cost levels, also known as tiers. Speak with your pharmacist to have your excluded brandname medication substituted with its generic equivalent. Where differences exist between this formulary and your benefit plan documents, the benefit plan documents rule. The medications listed on this formulary are subject to change pursuant to the formulary management. View the premium formulary to see the prescription drugs covered by the uva health plan. This plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the. This document contains information that is considered proprietary to optumrx and should not be reproduced without express written consent of optumrx. Frequently asked questions about transitioning to optumrx. Your 2016 prescription drug list optumrx 1 effective january 1, 2016. The information contained in the gchp list of covered drugs is provided solely for the.
If your medication is not listed here, please visit. Optumrx replaced cvscaremark on january 1, 2017 in administering prescription drug benefits for about 486,000 calpers members and their families. To help you get the most out of your pharmacy benefit, weve included some of the most commonly asked questions about the formulary. Remove all ranitidine products zantac if you have a prescription for a ranitidine drug zantac, stop taking it and contact your prescriber for an alternative. Countycare, an illinois medicaid plan serving cook county, will be making changes to the formulary effective 1101 2016. The formulary is also known as the prescription drug list pdl. Your 2020 comprehensive formulary administered by optumrx effective january 1, 2020 please read. Does the patient have a contraindication or intolerance to all formulary regimen alternatives.
However, due to formulary changes, some medications may be in different tiers, which could impact your cost share. Your prescription drug list formulary this formulary outlines the most commonly prescribed medications covered under your plans prescription drug benefits. This formulary applies to members of our unitedhealthcare west hmo medical plans with a pharmacy benefit. Optum essential health benefits enhanced comprehensive. Coverage for some drugs may be limited to specific dosage forms andor strengths.
Premium formulary drug list cefaclor nallpendextrose cephalexin penicillin g potassium in isoosmotic the optum drug list is a guide identifying generic, preferred brand name, and nonpreferred brand name medicines within select therapeutic categories. This comprehensive formulary was updated on august 28, 2019, and is a complete list of drugs covered by our plan. For the most uptodate formulary log onto the optumrx site or download the optumrx app. The drug list may not include all drugs covered by your prescription drug benefit. Visit your plans website on your member id card to. Locate an optumrx innetwork pharmacy look up possible lowercost medication alternatives. Existing utilizers of these medications will be allowed to continue on therapy. Table of contents click on any section or page below to go directly to that portion of the document. Medications are listed by categories or classes and are placed into cost levels known as tiers. Employee health, life and disability benefit program, the caterpillar inc. Visit or locate a participating retail pharmacy by zip code. Briovarx, the optumrx specialty pharmacy, can provide most of your specialty medications along with helpful programs and services. It includes both brand and generic prescription medications approved by the u.
September 12, 2016 all optum trademarks and logos are owned by optum, inc. Important contact information call customer service 18553126103 visit the member website. Formulary override exceptions prior authorization initial therapy you must answer all of the following questions 1. Your 2016 formulary signaturevalue threetier effective july 1, 2016 please read. Medicaid health plan common formulary changes effective april 1, 2020 drug class drug name new status. Prior authorization pa and related clinical call center operations preferred drug list pdl development and maintenance overthecounter otc drug formulary and pharmacy supplements formulary maintenance. This document includes a complete list of the drugs formulary for our plan and is current as of november 1, 2016. Optumrxs role is to work on the back end to process the claims on behalf of scrip world. Optumrx acts as the calpers pharmacy benefit manager for a majority of calpers its health plans. For an updated formulary drug list, please contact us. Search the list of fdaapproved drugs and coverage for each by entering a drug name below. Selectnationaladvantage formulary reference guide formulary disclaimer. This document contains information about some of the drugs we cover in this plan. A formulary is a list of prescribed medications chosen by your plan for their safety, cost and effectiveness.
Optumrx recognizes that drug therapy is an integral part of effective health management. As pbm for the feeforservice pharmacy benefit, optumrx has the following responsibilities. Optumrx threetier prescription drug plan for endowed faculty and staff. Optum essential health benefits comprehensive formulary.
Optumrx aso average for carvein and carveout clients combined, calendar year 2016 data. We realize that this formulary may not include every drug from every manufacturer. Your pharmacy benefit offers flexibility and choice in determining the right medication for you. Covered brandname drugs not on optumrx formulary plan features innetwork coverage preferred benefit level outofnetwork coverage. Please note, not all specialty medications are listed in the formulary. Has the patient tried and had an inadequate response to all formulary regimen. Please look at the benefit plan documents provided by y our employer or plan sponsor for full details. This document contains information about the drugs covered under your pharmacy bene t plan. Both generic and brand name prescriptions are offered. Drug list formulary effective january 1, 2020 for a complete list of covered drugs or if you have questions.
Your 2019 formulary for the most current list of covered medications or if you have questions. The benefit design determines what is covered and the applicable copayment. Your 2018 formulary signaturevalue fourtier this formulary is accurate as of january 2018 and is subject to change after this date. The below communication is being sent to members in september to alert them of the change of the types of glucose monitors and test strips that will be available in their formulary. The brandname medications below are excluded on the formulary. This site has been built to web content accessibility guidelines wcag standards. We are an optumtm company a leading provider of integrated health services. The prescription drug list pdl is a list of prescription medications commonly chosen by. Drug list formulary effective july 1, 2019 for a complete list of covered drugs or if you have questions.
Grandfathering will not be provided for any other excluded drugs. For pipeline products like these projected to have a significant market impact upon launch, the. Yes, during the second week of december 2016, the health plans. This formulary outlines the most commonly prescribed medications from your plans complete pharmacy. Your 2020 formulary for the most current list of covered medications or if you have questions. Optumrx threetier prescription drug plan for endowed. Optumrx will be the pharmacy benefits manager for your calpers prescription drug plan.
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