Important Message About What You Pay for Vaccines – Our plans cover most Part D vaccines at no cost to you. Call member services for more information.
Important Message About What You Pay for Insulin – You won’t pay more than $35* for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it's on.
Use the search options to see if a prescription drug is covered.
Choose your plan from the Select a Plan drop-down menu. Enter the full name or part of the name of the prescription drug
you are searching, or choose an option from the therapeutic category list. Then click the Search button.
If you need help finding a network provider or pharmacy or have a question about covered drugs, call member services toll-free at 1-800-222-8600, seven days a week, from 8 a.m. to 8 p.m. TTY users may call 711. If you contact us on a weekend or holiday, we will reach out to you within one business day. If you would like a Provider Directory or a Drug List mailed to you, you may call the number above, or request one here.
What is a Drug List?
A Drug List, or Formulary, is a list of prescription drugs covered by your plan. Your plan and a team of health care providers work together in selecting drugs that are needed for well-rounded care and treatment.
Review more information about our Drug List in our introduction to the Online Formulary.
If you are a provider and would like to make a prior authorization request, a tiering exception request or formulary exception request, download the Request for Medicare Prescription Drug Coverage Determination Form (40 KB) or visit https://professionals.optumrx.com.
*Peoples Health Group Medicare (HMO-POS) Office of Group Benefits members won’t pay more than $20 and People Health Group Medicare (HMO-POS) members won't pay more than $25. Peoples Health Secure Health (HMO-POS D-SNP) and Peoples Health Secure Complete (HMO-POS D-SNP) members pay $0 for covered insulin drugs.
Last updated 09/01/2023