We define a specialty medication as a high-cost, injectable, oral, infused, or inhaled medication if it has one or more of the following attributes:
The Specialty Pharmacy Program is available for specialty medications you take on your own. Because appropriate use of specialty medications is important to maintaining or improving your health and your quality of life, we designed a Specialty Pharmacy Program to provide the resources and personalized support you need to help you manage your condition.
Our Specialty Pharmacy Program offers support to help you manage your condition and connects you to a specialty pharmacy to get your medication. Take advantage of personalized patient support at no charge to you from knowledgeable pharmacists and nurses. In addition, you’ll receive:
Specialty medications are typically covered under both benefits. In general, medications that your doctor or another health professional provides in a physician office or infusion center are part of your medical benefit. Medications that you take on your own are usually part of your pharmacy benefit.
Specialty pharmacies offer more than just prescriptions. They provide extra services such as clinical support and focus primarily on specialty medications which need special handling and storage. For specialty medications you take on your own and are not given by a health care professional, we’re able to give you additional support through our Specialty Pharmacy Program.
Your new specialty pharmacy will be able to help you transfer your active prescriptions from your current pharmacy. If you’re out of refills, the specialty pharmacy will contact your doctor to get a new prescription.
You can refill your prescription by calling your specialty pharmacy directly. Otherwise, your specialty pharmacy will contact you each month, typically six to 10 days ahead of the next refill, to schedule your next delivery. If you’re not sure which specialty pharmacy will fill your medication, visit the Medications & Pharmacies page and click on/search for your medication.
You can even sign up for text message reminders online at myuhc.com or over the phone.
Depending on your benefit plan, you may need to use a participating specialty pharmacy. Please call the toll-free member phone number on the back of your health plan ID card. If you are required to use a specialty pharmacy and choose to use a regular pharmacy, you'll have to pay out-of-pocket or use out-of-network benefits.
All specialty pharmacies will deliver your medication to the location of your choice, at no additional cost to you. Once your delivery is scheduled, refrigerated medications will be delivered overnight directly to you, in a temperature-controlled package. Others will typically be shipped in one to three business days. Supplies will also be provided at no extra cost. To arrange delivery of your medication, contact your specialty pharmacy.
Supplies, such as sharps containers, needles, syringes and tubing necessary to administer an injectable specialty drug are provided at no cost to you by the specialty pharmacy. Talk with your specialty pharmacy to learn more.
Our Specialty Pharmacy Program only covers up to one-month supply of medications, depending on your current benefit plan and product packaging. We understand and realize this may be a change for you, and we will work with you to make this transition as easy as possible.
You can talk with a pharmacist at any time. Just call the toll-free member phone number that can be found on the label of your prescription or any printed documents that were sent to you including the Welcome Kit you received with your first shipment. Otherwise, you can always call the number on the back of your health plan ID card.
For even more personalized, one-on-one support, we offer the Clinical Management Program to you at no additional cost. Available for certain conditions, this program pairs you with a pharmacist or nurse. They will track your progress, help you maintain your therapy including managing side effects or remembering to take your medication, and answer any of your questions. To find out if this program is available to you, visit the Medications & Pharmacies page and click on/search for your medication.
Yes. To find out if a financial support program is available to you, visit the Medications & Pharmacies page and click on/search for your medication. You can also call us directly by using the phone number on the back of your health plan ID card.
Talk to your specialty pharmacy or visit the Environmental Protection Agency (EPA) website for more information on safe needle disposal options.
Your specialty pharmacist can answer your medication-related questions around-the-clock. If you're experiencing problems or are concerned about the effectiveness of your medication, be sure to also contact your doctor.
If you have additional questions about your medication, please call OptumRx at 1-888-739-5820. If you have additional questions about your benefits, please call the toll-free member phone number on the back of your health plan ID card. Si usted esta interesado en conocer mas sobre su beneficio de farmacia o si necesita asistencia leyendo esta información, por favor llame al 1-888-739-5820.
If you have questions about filling your prescription, ordering and delivery, or would like more information, check out our FAQs.