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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)
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

Pharmacy Program

 

Preferred Drug List and Updates

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

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

Preferred Drug List (PDL) Search
Preferred Drug List (PDL)
(PDF 2.08 MB)

4/1/2018 PDL Update (PDF 215.66 KB)
1/1/2018 PDL Update
(PDF 63.37 KB)
10/1/2017 PDL Update (PDF 59.58 KB)
7/1/2017 PDL Update (PDF 121.86 KB)


Step Therapy Program 

Step Therapy Policy (PDF 16.75 KB)


Drug Quantity Limits 

Quantity Limit Policy (PDF 24.38 KB)

 

Pharmacy Bulletins


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

Pharmacy Bulletins


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

Pharmacy Bulletins

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

Makena Frequently Asked Questions  (PDF 57.78 KB)


Prior Authorization List (PDF 413.96 KB)

 

Clinical Guidelines

Our Clinical Pharmacy Program Guidelines are updated on an ongoing basis by our Pharmacy and Therapeutics Committee. Our changes reflect recent developments in pharmaceutical health care so we’re aligned with national treatment standards.


UnitedHealthcare Connected® for MyCare Ohio
H2531-001

Pharmacy Program 

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by UnitedHealthcare Connected for MyCare Ohio
H2531-001.

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

Preferred Drug List (PDL) Search

Download (PDF 968.84 KB) the Acrobat version of the Preferred Drug List (PDL)


UnitedHealthcare Dual Complete® (HMO SNP)
H5253-059


UnitedHealthcare Dual Complete® (HMO-POS SNP)
H5322-028