UnitedHealthcare Community Plan
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NJ FamilyCare

Preferred Drug List (PDL) Search

Preferred Drug List (PDF 965.63 KB)

10/1/2016 PDL Update (PDF 69.78 KB)
8/1/2016 PDL Update  (PDF 66.77 KB)
5/1/2016 PDL Update (PDF 61.36 KB)
1/1/2016 PDL Update (PDF 57.73 KB) 
Step Therapy (PDF 21.03 KB)

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

Re-Review Reconsideration Request Form (PDF 158.04 KB)

 


UnitedHealthcare Dual Complete® ONE (HMO SNP)



Managed Long Term Services and Supports (MLTSS)

Preferred Drug List (PDL) Search
Preferred Drug List  (PDF 936.62 KB)
Step Therapy (PDF 21.03 KB)

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

Re-Review Reconsideration Request Form (PDF 158.04 KB)