UnitedHealthcare will no longer maintain this site effective October 1, 2017.
If you are a member, visit myuhc.com for details on your specialty pharmacy benefits and information regarding specialty medications.
If you are a provider, visit UHCprovider.com for a list of contracted specialty pharmacies by medication, the latest news, policy information and access to Link self-service tools.

Frequently Asked Questions
Find the answers to some of the most commonly asked questions about specialty medications and related services and benefits.
OVERVIEW

What is a specialty medication?

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:

  • Is self-administered or administered by a health care provider and used or obtained in either an outpatient or home setting.
  • Has special storage or handling requirements such as needing to be refrigerated.
  • May need close monitoring, on-going clinical management, and complete patient education and engagement.
  • May not be available at retail pharmacies.

What is the Specialty Pharmacy Program?

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.

What is included in the Specialty Pharmacy Program?

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:

  • Access to your medications
  • Pharmacists available 24/7
  • Support through clinical and adherence programs
  • Medication-related supplies at no additional cost
  • Proactive refill reminders
  • Timely delivery and shipping in confidential, temperature-sensitive packaging

Are specialty medications covered under the pharmacy or medical benefit?

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.

FILLING MY PRESCRIPTION

What is a specialty pharmacy? Why do I have to use one?

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.

Where can I get my specialty medications? How do I find a specialty pharmacy or provider?

  • Specialty medications you take on your own may need to be obtained from a specialty pharmacy, depending on your benefits. Finding a participating specialty pharmacy is easy. Just visit the Medications & Pharmacies page, and click on/search for your medication. To learn whether use of a participating specialty pharmacy is required for benefit coverage under your particular health plan, please call the toll-free member phone number on the back of your health plan ID card.
  • Specialty medications given by a health care professional are most commonly stocked in your doctor’s office or clinic or are provided to you in your home by a nurse from a home infusion provider, depending on your benefits. To find a provider, call the toll-free member phone number on the back of your health plan ID card.

How do I move or transfer my prescription to a specialty pharmacy?

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.

How do I refill my 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.

Can I continue to refill my specialty prescriptions at my regular pharmacy?

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.

COST

How much will my specialty medication cost?

  • For specialty medications you take on your own, most members will pay a copay. For costs specific to your benefit plan, please login to myuhc.com and click on "Manage my Prescriptions" or call the toll-free member phone number on the back of your health plan ID card.
  • For specialty medications given by a health care professional, most members will pay a coinsurance (percentage of the cost). For costs specific to your benefit plan, please call the toll-free member phone number on the back of your health plan ID card.
ORDERING AND DELIVERY

How will I receive my medication? Will it be delivered? When can I expect it?

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.

How do I get medication supplies such as syringes and sharps containers for used needles? Are they covered?

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.

I currently receive a 90-day supply of my medication. Can I continue to get a 90-day supply?

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.

ADDITIONAL SUPPORT

Want more support or to speak with a pharmacist?

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.

Are there any financial support programs available?

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.

Where can I find information on sharps disposal?

Talk to your specialty pharmacy or visit the Environmental Protection Agency (EPA) website for more information on safe needle disposal options.

What should I do if I have problems with my medication?

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.

Find Your Medication
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