UnitedHealthcare Community Plan
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Pharmacy Program

 

NJ FamilyCare

Pharmacy Program

 

Search Preferred Drug List (PDL)
Preferred Drug List (PDL) ( 993.78 KB)

7/1/2017 PDL Update (PDF 121.74 KB)
4/1/2017 PDL Update (PDF 63.3 KB)
1/1/2017 PDL Update
10/1/2016 PDL Update

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 


UnitedHealthcare Dual Complete® ONE (HMO SNP)
H3113-005



Managed Long Term Services and Supports (MLTSS)
Pharmacy Program

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 959.07 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