UnitedHealthcare Community Plan
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Pharmacy Program

 

HealthChoice

Pharmacy Program


Preferred Drug List (PDL) Search
Preferred Drugs List  (PDF 864.04 KB)


4/1/2017 PDL Update (PDF 63.34 KB)
1/1/2017 PDL Update (PDF 137.74 KB)
10/1/2016 PDL Update (PDF 52.13 KB) 
8/1/2016 PDL Update (PDF 63.65 KB)

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


Pharmacy Bulletins

Synagis Enrollment Form  (PDF 511.58 KB) 
Synagis Program  (PDF 58.92 KB)
Synagis Program 5 Doses (PDF 38.09 KB)

If your looking for HealthChoice Pharmacy Program Prior Authorization Forms, click here.

 

Medical Injectable Resources

Specialty pharmacy medications covered under a member’s medical benefit may be provided through a variety of channels – home infusion provider, outpatient facility, physician, or specialty pharmacy.

Click the arrow above to view more information.

For physicians who do not want to buy-and-bill a specialty pharmacy medication that is covered on the Medical Benefit, they may choose to source it through a network specialty pharmacy:

Network Specialty Pharmacy

Phone Number

OptumRx

866-218-7398

BioScrip (offers nursing services)

• also a National Home Infusion Provider for Medical Benefit medications

866-788-7710

The following specialty pharmacies may also provide specific categories of specialty pharmacy medications:

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (offers nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension


800-803-2523

 

Option Care (offers nursing services)

Cardiovascular/Heart Failure

Enzyme Deficiency

Gaucher's Disease

Hemophilia

Immune Globulin

Makena

866-827-8203

CVS Caremark Specialty Pharmacy

Enzyme Deficiency

Gaucher's Disease

Makena

Pulmonary Hypertension

800-237-2767

Coverage of the requested drug is dependent on the member's benefits, and the availability of a specific drug from a network specialty pharmacy may vary.

The Specialty Pharmacy can deliver the medication to the healthcare practitioner's office or another site (ex. patient's home) upon request, and the Specialty Pharmacy will bill the patient's health plan directly.

Pharmacy Prior Authorization Forms

Prior authorization is required for some services.

Click the arrow above to view a current list of services and information on how to request an authorization.

 

Specialty Pharmacy Prior Authorization Forms

Prior authorization is required for some services.

Click on the arrow above to view a current list of services and information on how to request an authorization.