UnitedHealthcare Community Plan
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Pharmacy Program

 

Florida Healthy Kids

Pharmacy Program


Preferred Drug List (PDL) Search
Preferred Drug List (PDF 1.77 MB)

7/1/2017 PDL Update (PDF 135.7 KB)
4/1/2017 PDL Update (PDF 63.29 KB)
1/1/2017 PDL Update (PDF 178.72 KB) 
10/1/2016 PDL Update (PDF 59.83 KB)

Step Therapy (PDF 21.02 KB)
Quantity Limits (PDF 20.11 KB)

 

Pharmacy Bulletins

Florida Healthy Kids Synagis Program (PDF 58.67 KB)
Florida Healthy Kids Synagis Enrollment Form (PDF 511.58 KB)
Florida Healthy Kids Synagis Program 5 Doses (PDF 51.26 KB)

 

Pharmacy Prior Authorization Guidelines

ICD-9 Diagnosis-Drug Match Policy and Diagnosis Code Table (PDF 168.64 KB)


Pharmacy Prior Authorization Forms


UnitedHealthcare Community Plan M*Plus (MMA)

Pharmacy Program 


The Preferred Drug List (PDL) is a list of prescription drugs. It is used for the UnitedHealthcare Community Plan and UnitedHealthcare government-paid health plans. View the Preferred Drug List.

1/1/2016 PDL Update (PDF 30.6 KB)

 

Pharmacy Prior Authorization Form

Re-Review Reconsideration Request Form (PDF 89.03 KB)


UnitedHealthcare Dual Complete® LP; (HMO SNP)
H1045-040


UnitedHealthcare Dual Complete® LP (HMO SNP)
H1045-039


UnitedHealthcare Dual Complete®RP (Regional PPO SNP)
R7444-012


UnitedHealthcare Dual Complete®RP ONE (Regional PPO SNP)
R7444-013


UnitedHealthcare Health & Home Connection