Labs must register their tests to participate as part of the Genetic and Molecular Lab Testing Notification/Prior Authorization process. They represent a portion of the resources used to support UnitedHealthcare … The Student Health Insurance Plan is provided through UnitedHealthcare Student Resources (UHCSR). This Prescription Drug List (PDL) is accurate as of Jan. 1, 2021 and is subject to change after this date. It describes benefits we offer to all members in all states. On your prescription benefits, you may see the name OptumRx®, which is UnitedHealthcare’s pharmacy service provider. You’ll find the detail about most prescription drug benefits by looking at your plan’s Prescription Drug List (PDL), also called a Formulary. It can help you get your prescriptions filled more easily and help you control costs too. You are not required to use OptumRx home delivery for a 90-/100-day supply of your maintenance medication If you have not used OptumRx home delivery, you must approve the first prescription order sent directly from your doctor to OptumRx before it can be filled. Student Health Insurance Administration. Refer to Care Provider Dispute Resolution (CA Delegates OR HMO claims, OR and WA Commercial Plans) section for more information. For people 65+ or those who qualify due to a disability or special situation, For people who qualify for both Medicaid and Medicare, Plans for people before age 65 and coverage to add on to other health insurance, Additional plans like student or life insurance, Learn how to sign in to your account if you get insurance through your employer, View individual and family plans near you, Managing medications (Prescription Drug Lists), Check your Prescription Drug List (PDL) often to stay ahead of changes in coverage, Talk to your doctor about lower-cost alternatives if a medication is too expensive. Prescription Drugs Mail order through UHCP at 2.5 times the retail Copayment up to a 90-day supply. Get answers to your questions here. UnitedHealthcare members with health plans through an employer may use the UnitedHealthcare app to help manage their medications. If you have medications you take regularly, watch your PDL and track changes to stay ahead of possible changes in cost. This directory includes care providers who serve our Commercial, Medicaid / Community Plan (excludes United Healthcare Community Plan of Rhode Island ) and Medicare members. Maybe you take regular medications — or maybe you’ve only needed medication for specific treatments. UnitedHealthcare Student Resources: UnitedHealthcare Student Resources P.O. Ordering care providers will complete the notification/prior authorization process online or over the phone. If you don’t use a participating network pharmacy, you may have to pay the full retail price for your prescriptions. It’s a list of medications and how they’re covered by your plan. To better understand the procedures and protocols we follow to help to ensure your privacy, please review the following information: You can view list of pharmacies for your plan by signing in to your health plan account. Students - Customer Service: 1-800-767-0700 MAIL. Choosing a network pharmacy may help you save on costs. $10 Copayment for Tier 1 $20 Copayment for Tier 2 Up to a 30 day supply per prescription filled at a UnitedHealthcare Pharmacy (UHCP) $10 Copayment for Tier 1 $20 Copayment for Tier 2 $20 Copayment for Tier 3 Up to a 30 day supply Lost your member ID card? Your customized benefits are supported by our flexibility - unique Student Health Center billings, pharmacy claims, referral requirements and customized administrative reports. Doctors: You may receive care from any doctor or hospital. Student health plans can be a valuable solution for college-bound students and their families. The largest amount of medication your plan will cover per copayment or period of time. Get information on lower-cost prescription alternatives, if available, to help save members money. Find a local pharmacy that's convenient for you. ... Talk to your UnitedHealthcare representative for more details. Prescription Drugs Prescription Drugs covered under the Preventive Care Services benefit will be paid at the benefit levels shown under Preventive Care … Worldwide assistance services (medical evacuation and repatriation) UnitedHealthcare Global: Toll-free within the United States: 1-800-527-0218 At times, a similar drug can work just as well — like if there’s a generic version of the drug. These costs are decided by your employer or health plan. PharmD and eligibility for pharmacy licensure in MN required; experience in a community pharmacy setting a plus. Prescribed by a health care professional such as your doctor, For services performed by a network health care professional, For products and drugs filled at a network pharmacy. Starting Nov. 1, 2017, notification is required for certain genetic and molecular lab tests for certain UnitedHealthcare Commercial benefit plans. Box 809025 Dallas, TX 75380-9025 Phone: 1-866-948-8472 Email: GKClaims@uhcsr.com Website: www.uhcsr.com. At UMR, we are very sensitive to privacy issues. Let’s walk through some tips on how to use your pharmacy benefits for prescription drugs. Find a local dentist or dental care in your area. Claim reconsideration does not apply to some states based on applicable state law. If you’ve ever needed prescription drugs, you know they can play an important role in keeping you healthy. A Prescription Drug List (PDL) – also called a formulary – is a list of commonly used medications, organized into cost levels, called tiers. UMR is a UnitedHealthcare company. A requirement that your doctor explains why you need a certain medication before your plan decides how and if it will be covered. Shop AARP Medicare Advantage, Medicare prescription drug, Medicare Supplement Insurance and Medicare Special Needs plans from UnitedHealthcare. This PDL applies to members of our UnitedHealthcare and Student Resources medical plans with a pharmacy benefit subject to the Traditional 4-Tier PDL. Call the phone number on your health plan ID card. Plan Administration UnitedHealthcare StudentResources 2301 West Plano Parkway, Suite 300 Plano, TX 75075 Mail your claims to: UnitedHealthcare StudentResources P.O. Learn about our prescription benefits and health networks now. Medications used to treat complex or rare conditions that you may need to get from a specialty pharmacy. A referral from a Student Health Care Center provider may be necessary when using the UF insurance plan. Call the phone number on your health plan ID card. Our Drug Cost Estimator lets you see what you can expect to pay for Medicare Part D prescription drugs. Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines, and Utilization Review Guidelines are developed as needed, are regularly reviewed and updated, and are subject to change. You can sign in to your health plan account and look under your pharmacy and prescription coverage information to see your plan’s PDL. Want to access your card online? ©2020 United HealthCare Services, Inc. Careers - Opens in a new window. You can ask about a lower cost alternative if the drug your doctor chooses is too expensive or isn’t covered. If you need to seek medical care or get a prescription before you receive your insurance card, please … Your privacy is important to us! 20PPOSB-315-2 Page 3 of 6 UnitedHealthcare StudentResources maximums and Copays as described in the plan certificate. By that time it … StudentResources administration skills have been honed over decades of managing student health insurance plans. When your doctor prescribes medication, look at your list and talk about the cost. No matter what, it’s helpful to know how your benefits work. You may be able to order up to a 3-month supply of medication you regularly take — and there’s usually no charge for standard shipping within the U.S. You can enroll in just a few steps when you sign in to your health plan account or call the number on your member ID card. If the customer has a UnitedHealthcare Student Resources plan, but uses a third-party behavioral health vendor, then Some medications have quantity limits for quality and safety reasons. This summary is applicable to fully insured and self-funded UnitedHealthcare Student Resources plans using the Medical Necessity Model and that also use United Behavioral Health (“Optum”) as their behavioral health vendor. Check current prescription coverage and price, including out-of-pocket prescription costs for UnitedHealthcare members at their selected pharmacy with the PreCheck MyScript Solution within your EMR or on Link. You may also view a general PDL, but you’ll need to confirm your specific coverage details before filling a prescription. Student Medicover is committed to attacking the greatest healthcare challenges for international students – inflated prices, confusing terms, and complicated processes. OptumRx is an affiliate of UnitedHealthcare Insurance Company. Insurance for Graduate Students on an Assistantship This plan is provided to eligible graduate student assistants as a benefit. You can also view a general list of pharmacies using the OptumRx Pharmacy Network Search. For people 65+ or those who qualify due to a disability or special situation, For people who qualify for both Medicaid and Medicare, Plans for people before age 65 and coverage to add on to other health insurance, Additional plans like student or life insurance, Learn how to sign in to your account if you get insurance through your employer, View individual and family plans near you, Managing medications (Prescription Drug Lists), Specialty medications not eligible for coupons, Advantage Tier 3 Prescription Drug List for UnitedHealthcare, Neighborhood Health Plan, River Valley, All Savers, and Oxford medical plans, Advantage Tier 4 Prescription Drug List for UnitedHealthcare, Golden Rule, UnitedHealthOne, Oxford, All Savers, Neighborhood Health Plan and River Valley medical plans, Access Tier 3 Prescription Drug List for UnitedHealthcare, Neighborhood Health Plan, River Valley and Oxford medical plans, Access Tier 4 Prescription Drug List for UnitedHealthcare, Neighborhood Health Plan, River Valley and Oxford medical plans, Traditional Tier 3 Prescription Drug List for UnitedHealthcare, River Valley, Oxford and Student Resources medical plans, Traditional Tier 4 Prescription Drug List for UnitedHealthcare and Student Resources medical plans, Essential Tier 4 Prescription Drug List for UnitedHealthcare, All Savers, Golden Rule, Neighborhood Health Plan and River Valley medical plans, Your Right to Request an Exclusion Exception, Standard Tier 4 PPO Prescription Drug List CDI Version, Standard Tier 4 HMO and PPO Prescription Drug List DMHC Version, Large Group Tier 3 PPO Prescription Drug List CDI Version, Large Group Tier 3 HMO and PPO Prescription Drug List DMHC Version, Large Group Tier 4 PPO Prescription Drug List CDI Version, Large Group Tier 4 HMO and PPO Prescription Drug List DMHC Version, Access Tier 3 PPO Prescription Drug List CDI Version, Access Tier 3 HMO and PPO Prescription Drug List DMHC Version, Access Tier 4 PPO Prescription Drug List CDI Version, Access Tier 4 HMO and PPO Prescription Drug List DMHC Version, Essential Tier 4 Prescription Drug List DMHC Version, Essential Tier 4 Prescription drug List DMHC Version, UHC Advantage Tier 3 Prescription Drug List, UHC Advantage Tier 4 Prescription Drug List, UHC Traditional Tier 3 Prescription Drug List, Oxford Advantage Tier 3 Prescription Drug List, Oxford Advantage Tier 4 Prescription Drug List, Oxford Traditional Tier 3 Prescription Drug List, Oxford Access Tier 3 Prescription Drug List, Traditional Tier 3 Prescription Drug List, Traditional Tier 4 Prescription Drug List, Advantage Plan Drugs Requiring Preauthorization, Traditional Plan Drugs Requiring Preauthorization, River Valley Pharmacy program 90/100 day list, Advantage and Essential Zero Cost Share Preventive Medications, Traditional, Access and Enhanced Zero Cost Share Preventive Medications, SignatureValue Zero Cost Share Preventive Medications, Advantage and Essential HMO and PPO Zero Cost Share Preventive Medications, Traditional, Access and Enhanced HMO and PPO Zero Cost Share Preventive Medications, Traditional and Access Zero Cost Share Preventive Medications, Emergency Contraceptive Services Only drug list, CT/DC/DE/IL/MA/MD/OR/WA Contraceptive Services Only drug list, Preventive Medication List: Core (1/1/2021), Preventive Medication List: Core (9/1/2020), Preventive Medication List: Core Plus (1/1/2021), Preventive Medication List: Core Plus (9/1/2020), Preventive Medication List: Expanded (1/1/2021), Preventive Medication List: Expanded (9/1/2020), Preventive Medication List: Federal Guided (1/1/2021), Preventive Medication List: Federal Guided (9/1/2020), Preventive Medication List: Universal (1/1/2021), Preventive Medication List: Universal (9/1/2020). The information is a summary and is subject to change, as of December 12, 2020. Find a Pharmacy Find a Dentist. UnitedHealthcare, River Valley, Oxford, and Student Resources medical plans with a pharmacy benefit subject to the Traditional 3-Tier PDL. When your plan requires you to try one or more medications before approving coverage for a different one. Try it now to understand your coverage options. A second-year specialty residency will be considered for individuals who have completed a general practice residency (with stipend adjustment). I was given a number and told that my doctor needed to contact United Health Care and authorize this prescription if I were to ever get my dexcom. With some plans, you have the choice to fill your prescriptions at a participating network pharmacy or with home delivery by mail. 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