UnitedHealthcare Community Plan
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UnitedHealthcare Community Plan

Preferred Drug List (PDL) Search


Preferred Drug List  (PDF 965.8 KB)

10/1/2016 PDL Update (PDF 66.17 KB)
8/1/2016 PDL Update (PDF 63.08 KB)
5/1/2016 PDL Update (PDF 54.93 KB)
1/1/2016 PDL Update (PDF 54.27 KB)
Prior Authorization List  (PDF 417.51 KB)
Step Therapy Policy  (PDF 16.75 KB)
Quantity Limit Policy (PDF 24.38 KB)


Pharmacy Bulletins

Synagis Enrollment Form (PDF 113.79 KB)  
Synagis Program 
(PDF 53.22 KB)
Synagis Program 5 Doses (PDF 51.26 KB)

Prior Authorization and Medical Exception Forms

Re-Review Reconsideration Request Form (PDF 158.04 KB)


UnitedHealthcare Connected® for MyCare Ohio

Preferred Drug List (PDL) Search

Download the Acrobat version of the Preferred Drug List (PDL)

UnitedHealthcare Dual Complete® (HMO SNP)