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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)
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


Specialty Pharmacy 

Specialty pharmacy medications covered under the member’s medical benefit may be provided through a various sources ‒ home infusion provider, outpatient facility, physician, or specialty pharmacy.

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

Network Specialty Pharmacy

Phone Number



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

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (offers nursing services)

Immune Globulin

Pulmonary Hypertension



Option Care (offers nursing services)

Immune Globulin



CVS Caremark Specialty Pharmacy

Pulmonary Hypertension


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

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

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


Healthy Michigan Plan

UnitedHealthcare Community Plan

Pharmacy Program 

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

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

Preferred Drug List (PDL) Search

Managed Care Common Formulary

Michigan Prior Authorization Request Form for Prescription Drugs  (PDF 179.55 KB)

Medication Coverage in Addition to Common Formulary List (PDF 56.96 KB)

Pharmacy Bulletins

Synagis Enrollment Form (PDF 112.99 KB) 
Synagis Program (PDF 58.92 KB)



Preferred Diabetic Testing Supplies

Diabetic Supply Changes Effective Jan. 1, 2016

To help provide our members with clinically appropriate, cost-effective diabetic supplies, UnitedHealthcare Community Plan has selected LifeScan (OneTouch®) as the preferred manufacturer for diabetic blood glucose meters and test strips.

As of Jan. 1, 2016, only LifeScan (OneTouch) meters and test strips are included on the Preferred Drug List. The LifeScan meters are offered at no cost for members. Other tests strip manufacturers, including Roche (Accu-Chek®), are no longer preferred and have been removed from the Preferred Drug List.  



Accu-Chek Meters:

  • Accu-Chek Aviva Plus
  • Accu-Chek Aviva Connect
  • Accu-Chek Aviva Expert
  • Accu-Chek Compact Plus

One-Touch Meters:

  • OneTouch UltraMini Meter
  • OneTouch Ultra 2 Meter
  • OneTouch Verio Meter
  • OneTouch Verio IQ Meter
  • OneTouch Verio Sync Meter

Accu-Chek Test Strips:

  • Accu-Chek Aviva Plus Test Strips
  • Accu-Chek SmartView Test Strips
  • Accu-Chek Compact Test Strips
  • Accu-Chek Comfort Test Strips
  • Accu-Chek Active Test Strips

One-Touch Test Strips:

  • OneTouch Ultra Test Strips
  • OneTouch Verio Test strips


What We’re Asking You to Do


Please encourage your patients to use products on the Preferred Drug List, and provide them with a new prescription for these products.

If the preferred alternative testing supplies are not appropriate for your patients, they may still obtain the non-preferred brand through a Durable Medical Equipment (DME) care provider and you won’t need to do anything different to keep your patient on the non-preferred product.


We’re Here to Help


If you have questions, please call Provider Services at 800-903-5253, Monday through Friday, 8:30 a.m. to 5:30 p.m. Eastern Time.

View the preferred testing supply notice (PDF 42.89 KB). 


UnitedHealthcare Dual Complete® (HMO SNP)