UnitedHealthcare Community Plan
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Children with Special Health Care Needs

Preferred Drug List (PDL) Search

Preferred Drug List (PDF 861.38 KB)

1/1/2017 PDL Update (PDF 227.42 KB) 
10/1/2016 PDL Update (PDF 51.69 KB)
8/1/2016 PDL Update  (PDF 66.02 KB)
5/1/2016 PDL Update  (PDF 59.61 KB)
 Step Therapy (PDF 21.03 KB)

Pharmacy Bulletins

Suboxone PA request FAQs (PDF 290.23 KB)
Synagis Enrollment Form (PDF 511.58 KB)  
Synagis Program (PDF 58.92 KB)  
Synagis Program 5 Doses (PDF 51.26 KB)

Direct Acting Antiviral (DAA) Policy (PDF 111.03 KB)


Pharmacy Prior Authorization Forms

Re-Review Reconsideration Request Form (PDF 158.04 KB)


UnitedHealthcare RIte Care

Preferred Drug List (PDL) Search

Preferred Drug List (PDF 861.38 KB)
PDL Updates (PDF 48.99 KB)
Step Therapy (PDF 21.03 KB)

 

Pharmacy Bulletins

Suboxone PA request FAQs (PDF 290.23 KB)
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 Rhody Health Partners

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 861.38 KB)
PDL Updates (PDF 48.99 KB)
Step Therapy (PDF 21.03 KB)
Pharmacy Bulletins

Suboxone PA request FAQs (PDF 290.23 KB)
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 Rhody Health Partners ACA Adult Expansion

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 861.38 KB)
PDL Updates (PDF 48.99 KB)
Step Therapy (PDF 21.03 KB)
Pharmacy Bulletins

Suboxone PA request FAQs (PDF 290.23 KB)
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)