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Pharmacy Program

 

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Looking for Paper Pharmacy Prior Authorization Fax Forms? They are now available at UHCprovider.com 

 

Opioid Program and Resources

In response to the U.S. opioid epidemic, UnitedHealthcare has developed programs to help our members receive the care and treatment they need safely and effectively.

We’ve also established measures based on the Centers for Disease Control and Prevention’s (CDC) opioid treatment guidelines to help prevent overuse of short-acting and long-acting opioid medications.

Resources from UnitedHealthcare and Optum

Medicated Assisted Treatment: Locate a Provider (PDF 84.58 KB)
Naloxone Coverage for UnitedHealthcare Members
(PDF 323.61 KB)
Naloxone: What You Need to Know
(PDF 62.67 KB) (PDF 102.65 KB)
Opioid Informed Consent Template (PDF 53.25 KB)
Opioid Tapering Recommendations (PDF 102.65 KB)
The Role of Dentists in Managing Opioids
(PDF 448.16 KB)
Treatment Alternatives for Common Pain Conditions 
(PDF 96.61 KB)


Other Resources

Agency for Healthcare Research and Quality (AHRQ)
Interagency Guideline on Prescribing Opioids for Pain

Centers for Disease Control and Prevention (CDC)
CDC Guideline for Prescribing Opioids for Chronic Pain (2016)
CDC Opioid Overdose Guideline Resources

Substance Abuse and Mental Health Services Administration (SAMHSA)
The Role of Prevention in Addressing Neonatal Abstinence Syndrome

 

UnitedHealthcare Community Plan
QUEST Integration Program

Pharmacy Program

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by UnitedHealthcare Community Plan QUEST Integration Program.

Click on the link below to view the Preferred Drug List.

Preferred Drug List (PDL) Search

UnitedHealthcare Community Plan - QUEST Program Preferred Drug List (PDF 1.3 MB)

4/1/2018 PDL Update (PDF 221.49 KB)
1/1/2018 PDL Update (PDF 165.72 KB) 
10/1/2017 PDL Update (PDF 61.28 KB)
7/1/2017 PDL Update (PDF 122.73 KB)

Step Therapy Information

Step Therapy Policy (PDF 21.02 KB)


Quantity Limit Initiatives

Quantity Limit Policy (PDF 20.1 KB)


Direct Member Reimbursement

Direct Member Reimbursement Form (PDF 194.84 KB)

 

Pharmacy Bulletins

Synagis Enrollment Form (PDF 225.02 KB) 
Synagis Program (PDF 59.42 KB)
Synagis Program 5 Doses (PDF 51.26 KB)

 


UnitedHealthcare Dual Complete® (PPO SNP)
H2228-043


UnitedHealthcare Dual Complete® RP (Regional PPO SNP)
R3175-003

Pharmacy Program 

 

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by UnitedHealthcare Dual Complete RP (Regional PPO SNP) R3175-003.

Click on the link below to view the Preferred Drug List.

Preferred Drug List (PDL) Search

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

Submit a Pharmacy Prior Authorization Request to Prescription Solutions.

Medicare Prescription Drug Determination Request Form