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Pharmacy Program



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


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)
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)
Guideline for Prescribing Opioids for Chronic Pain (2016)
Opioid Overdose Guideline Resources

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



Pharmacy Program

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by HealthChoice.

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

Preferred Drug List (PDL) Search
Preferred Drug List  (PDF 1.71 MB)

7/1/2018 PDL Update (PDF 69 KB) 
4/1/2018 PDL Update (PDF 220.6 KB)
1/1/2018 PDL Update (PDF 62.33 KB)
10/1/2017 PDL Update (PDF 58.1 KB)


Step Therapy Program 

Step Therapy (PDF 21.02 KB)

Drug Quanitity Limits 

Quantity Limits
Quantity Limits for Opioids
(PDF 132.82 KB)

Pharmacy Bulletins

Synagis Enrollment Form  (PDF 112.99 KB) 
Synagis Program  (PDF 58.92 KB)
Synagis Program 5 Doses (PDF 38.09 KB)


Specialty pharmacy medications covered under the member’s medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacy:

Network Specialty Pharmacy

Phone Number



The following specialty pharmacies also provide certain types of specialty medications:

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension



Option Care (nursing services)

Enzyme Deficiency

Gaucher's Disease


Immune Globulin



CVS Caremark Specialty Pharmacy

Pulmonary Hypertension


Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.