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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

Prior authorization is required for some services and medications. A current list of prior authorization services, medications and forms can be found below.

Children with Special Health Care Needs

Pharmacy Program

 

Preferred Drug List and Updates

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by Children with Special Health Care Needs.

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

Preferred Drug List (PDL) Search
Preferred Drug List
(PDF 1.58 MB)

4/1/2018 PDL Update (PDF 221.32 KB)
1/1/2018 PDL Update (PDF 122.46 KB)
7/1/2017 PDL Update (PDF 131.46 KB)
4/1/2017 PDL Update (PDF 60.71 KB)
 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)

 

Specialty Pharmacy 

BriovaRx, the OptumRx specialty pharmacy, is a leading specialty pharmacy services company dedicated to helping administer and deliver high-quality, cost-effective specialty pharmacy care.

Specialty Pharmacy Information

 

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® (HMO SNP)
H3113-010


UnitedHealthcare RIte Care

Pharmacy Program 

 

Preferred Drug List and Updates

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

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

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 1.58 MB)

4/1/2018 PDL Update (PDF 221.32 KB)
1/1/2018 PDL Update (PDF 122.46 KB)
7/1/2017 PDL Update (PDF 131.46 KB)
4/1/2017 PDL Update (PDF 60.71 KB)

 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)

 

Specialty Pharmacy

BriovaRx, the OptumRx specialty pharmacy, is a leading specialty pharmacy services company dedicated to helping administer and deliver high-quality, cost-effective specialty pharmacy care.

Specialty Pharmacy Information

 

Pharmacy Bulletins

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

 


UnitedHealthcare Rhody Health Partners

Pharmacy Program 

 

Preferred Drug List and Updates

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

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

Preferred Drug List (PDL) Search
Preferred Drug List (PDF 1.58 MB)

4/1/2018 PDL Update (PDF 221.32 KB)
1/1/2018 PDL Update (PDF 122.46 KB)
7/1/2017 PDL Update (PDF 131.46 KB)
4/1/2017 PDL Update (PDF 60.71 KB) 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)

 

Specialty Pharmacy

BriovaRx, the OptumRx specialty pharmacy, is a leading specialty pharmacy services company dedicated to helping administer and deliver high-quality, cost-effective specialty pharmacy care.

Specialty Pharmacy Information

 

Pharmacy Bulletins

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

 


UnitedHealthcare Rhody Health Partners ACA Adult Expansion

Pharmacy Program 

 

Preferred Drug List and Updates

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by Rhody Health Partners ACA Adult Expansion.

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

Preferred Drug List (PDL) Search
Preferred Drug List  (PDF 1.58 MB)

4/1/2018 PDL Update (PDF 221.32 KB)
1/1/2018 PDL Update (PDF 122.46 KB)
7/1/2017 PDL Update (PDF 131.46 KB)
4/1/2017 PDL Update (PDF 60.71 KB)

 

Step Therapy Program 

Step Therapy (PDF 21.03 KB)

 

Specialty Pharmacy

BriovaRx, the OptumRx specialty pharmacy, is a leading specialty pharmacy services company dedicated to helping administer and deliver high-quality, cost-effective specialty pharmacy care.

Specialty Pharmacy Information

 

Pharmacy Bulletins

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