UnitedHealthcare Community Plan
You appear to be browsing this site using Internet Explorer 6. This browser is now out of date. For safer, more reliable browsing it is recommended that you upgrade your browser to Firefox, Safari or Internet Explorer 7 or 8.
Shortcut Navigation:
Please select the state where you practice.

Pharmacy Program 

 

Medicaid Pharmacy Benefit Frequently Asked Questions (PDF 246.66 KB)

 

UnitedHealthcare Community Plan - Heritage Health

Pharmacy Program 


Pharmacy Bulletins

Synagis Enrollment Form (PDF 511.58 KB)  
Synagis Program (PDF 58.92 KB) 
Synagis Program 5 Doses (PDF 51.26 KB)

Pharmacy Prior Authorization Forms

Nebraska General Prior Authorization Request Form (PDF 136.7 KB)

 

Specialty Pharmacy Medications

 

Specialty Pharmacy Medications
Specialty Pharmacy Medications
Specialty Pharmacy Medications
Medical Injectables

Specialty pharmacy medications covered on the Medical Benefit may be provided through a variety of channels – home infusion provider, outpatient facility, physician, or specialty pharmacy.

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 through a network specialty pharmacy:

Network Specialty Pharmacy

Phone Number

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 Contact Information

 

Rx Claims Processing Technical Assistance: Contact the OptumRx Help Desk at
877-231-0131, 24 hours a day, 7 days a week.

Pharmacy Prior Authorization Assistance: Contact our Pharmacy Prior Authorization line at 800-310-6826.

Medical DME Questions: Contact our Provider Service Center at 866-331-2243.

 

State of Nebraska Preferred Drug List

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by the Nebraska Department of Medicaid. View the PDL as produced by the state of Nebraska:

NE Preferred Drug List

UHC Preferred Drug List (PDF 1.29 MB)

Pharmacy Preferred Drug List (PDL) Lookup Tool

 

Pharmacy Providers Dispensing Durable Medical Equipment (DME)

 If you would like to be contracted for DME services offered to UnitedHealthcare Community Plan - Heritage Health members, contact Sr. Network Account Manager Angela Hogan at: 

Email : Angela_hogan@uhc.com
Phone: 952-406-4955
Toll Free:  800-284-0626
Fax:  888-868-5011

 

MAC Price Lookup and Appeals

Nebraska MAC Price Lookup

MAC Appeal Submission Guide