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Pharmacy Program

 

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

 

Pharmacy Prior Authorization Forms for NJ FamilyCare and Managed Long Term Services and Supports (MLTSS) Pharmacy Program Plans

Prior authorization is required for some services and medications. Click the arrow below to view a current list of services and information on how to request an authorization.

NJ FamilyCare

Pharmacy Program

 

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

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

Search Preferred Drug List (PDL)
Preferred Drug List (PDL) (PDF 1.1 MB)

4/1/2018 PDL Update  (PDF 166.29 KB) 
1/1/2018 PDL Update (PDF 163.48 KB)
10/1/2017 PDL Update (PDF 60.14 KB)
7/1/2017 PDL Update (PDF 121.74 KB)

 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)


Pharmacy Bulletins

Synagis Enrollment Form (PDF 225.02 KB)  
Synagis Program  (PDF 58.92 KB)
Synagis Program 5 Doses (PDF 51.26 KB)

 


UnitedHealthcare Dual Complete® ONE (HMO SNP)
H3113-005



Managed Long Term Services and Supports (MLTSS) Pharmacy Program

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by Managed Long Term Services and Supports. Click on the link below to view the Preferred Drug List.

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 1.09 MB)

 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)


Pharmacy Bulletins

Synagis Enrollment Form (PDF 225.02 KB)  
Synagis Program (PDF 58.92 KB) 
Synagis Program 5 Doses (PDF 51.26 KB)