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How prescription drug benefits work

UnitedHealthcare administers your prescription drug benefits. You may purchase covered prescriptions through the UnitedHealthcare pharmacy:
  • At a participating retail pharmacy, including many chain and local pharmacies
  • Through the mail from the convenient home delivery service (for long-term maintenance medications)
Benefits for covered prescription drugs are payable whether or not you use a pharmacy in the UnitedHealthcare network, although your out-of-pocket costs are lower when you use participating pharmacies.
If you are enrolled in a UHC PPO plan, your prescription drug copays apply toward your medical in-network, out-of-pocket maximum.
If you are enrolled in the UHC Basic or Premium HSA medical plan, you will pay the full cost of your non-preventive prescriptions until you meet the deductible, just like with the rest of your eligible medical expenses. Prescription costs count toward meeting your plan deductible and out-of-pocket maximum in the UHC HSA medical plans.
Preferred drug list – for all UHC Plans
The UnitedHealthcare/OptumRx™ program includes a preferred drug list (PDL) called the Advantage PDL. The PDL is a guide to help providers prescribe cost-effective medication. Use of the list is completely voluntary for you and your provider.