Not sure if these drug lists apply to your benefit plan? Check your benefit plan document or call the Customer Service number on your member ID card. A language line is available for translation for most languages.
Our prescription drug lists are lists of prescription medications that have been reviewed and recommended by our Medical and Pharmacy Management Committee. Feel good knowing that each medication has been reviewed for safety, effectiveness, clinical outcomes and cost.
You can use drug lists to see if a medication is covered by your health insurance plan. You can also find out if the medication is available as a generic, needs prior authorization, has quantity limits and more.
• $0 Covered Drug List
The Affordable Care Act (ACA) requires most health plans to cover certain drugs at no cost to members. View the $0 Covered Drug List.
• Excluded Drug List
There are some medications that our pharmacy benefits don’t cover. There may be safe, effective, less costly options. View the Excluded Drug List.
• Preferred Drug List
Most of our plans use the Preferred Drug List (PDL). Doctors and pharmacists developed the PDL based on safety, efficacy and cost-effectiveness. You’ll save money when you use the drugs on this list. Of course, it’s up to you and your doctor to decide which medicines you’ll use.
• Specialty Drug List
The drugs on the Specialty Drug List treat complex or chronic conditions such as cancer, rheumatoid arthritis, multiple sclerosis and hepatitis, just to name a few. You may pay a different copay or coinsurance for these drugs. And certain rules may apply.
NOTE: The preferred drug list is subject to change without notice at any time during the year without prior notice to members or physicians. For updated preferred drug list information, click on the OptumRx icon on this page or call the Pharmacy Customer Service Number on your member ID card.