FAQs
What do I do if my medication needs a PA? To begin the PA process, you can: • Let your doctor know that a PA is needed for your medication. Call Optum Rx toll-free at 1-855-828-9834 (TTY: 711).
What is the phone number for Optum RX appeals? ›
If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.
What is the phone number for OptumRx PA Dept? ›
Submitting a PA request to OptumRx via phone or fax
above. For urgent requests, please call us at 1-800-711-4555.
What are the criteria for OptumRx zepbound? ›
Zepbound® is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of: • 30 kg/m2 or greater (obesity) or • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., ...
How do I override my OptumRx prescription? ›
If an override is available, there will be a Request Override button at the bottom of the claim card • Note: The option to request an override will not appear if the claim has any additional rejections other than refill too soon. If the option is not available, contact the Pharmacy Help Desk.
How long does it take to get meds from OptumRx? ›
Order delivery time and shipping options
Once OptumRx receives your complete order for a new prescription, your medications should arrive within ten business days. Completed refill orders should arrive to your home in about seven business days.
How do I call OptumRx for prescriptions? ›
Call 1-800-791-7658
Provide a verbal prescription directly to one of our provider dedicated pharmacists.
How do I appeal an OptumRx denial? ›
For more information on the OptumRx Claim Reimbursem*nt Review/Appeal request process: Contact OptumRx at 1-800-613-3591 extension 9, Monday through Friday, 6 AM – 4 PM PT, or your OptumRx Provider Liaison; or the Call Center at 800-424-5815 to request a reimbursem*nt price.
Is OptumRx part of UnitedHealthcare? ›
You may see the name Optum Rx on your prescription benefits. This is the UnitedHealthcare pharmacy service provider. Optum Rx offers coverage through a large network of retail chain pharmacies and independent pharmacies. It also offers coverage through its mail order pharmacy, Optum Home Delivery®.
Why does OptumRx keep calling me? ›
Many people are receiving calls, primarily on their cell phones, from Optum RX, which they have not consented to receive. These are automated calls or robocalls, which violate the Telephone Consumer Protection Act (TCPA).
Registration at optumrx.com takes just a few minutes.
- To set up a HealthSafe ID, enter your health plan number. If you don't have your ID card, enter your Social Security number and ZIP code.
- Choose a username and password.
- Enter your email address.
- Enter your phone number or choose your security questions.
OptumRx® and CVS Pharmacy® make it easy for you to get your maintenance medications and may save you money. 1 The OptumRx CVS90 Saver program allows you to get 90-day supplies of your maintenance medications at nearly 9,700 CVS Pharmacy locations or through OptumRx home delivery — the choice is yours.
Why was I denied Zepbound? ›
Your insurance company may question whether Zepbound is medically necessary for you. Some insurers deny coverage of prescription weight loss drugs for weight management if you don't have another medical issue, like type 2 diabetes, or your BMI isn't in the approved range.
Is Zepbound worth the money? ›
Zepbound has an average rating of 9.1 out of 10 from a total of 78 reviews for the treatment of Weight Loss (Obesity/Overweight). 87% of reviewers reported a positive experience, while 0% reported a negative experience.
What weight loss medication will OptumRx cover? ›
Optum Rx standard formularies currently include the weight loss drugs Wegovy and Saxenda, and the PBM is evaluating Zepbound. Beginning Jan. 1, 2024, Optum Rx will begin offering plan sponsors a new weight management and wellness support program.
What is the job description of OptumRx prior authorization? ›
JOB SUMMARY: Primary responsibility: To obtain prior authorization for all medical procedures, surgeries, or DME. Calls patients prior to surgery with payment information.
How do I submit an RX to OptumRx? ›
You can submit your order via phone, mail, online or through the OptumRx App. Additionally, your physician can electronically submit your prescription to OptumRx. OptumRx fills your order and mails it to you within seven days of placing the order.
Can I transfer a prescription from OptumRx to CVS? ›
Register at optumrx.com. Bring in your prescriptions or empty prescription bottles and the pharmacist will do the rest. Call your local CVS Pharmacy and a pharmacy staff member will help you. Transfer your prescriptions in a few simple steps.
Can I use Walgreens with OptumRx? ›
Your pharmacy network
For most medications you take regularly (maintenance medications), you must use the OptumRx home delivery pharmacy or a Walgreens pharmacy for 90-day supplies.
