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. 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. If you have a prescription for a certain kind of medication, you can look it up in your PDL to see how it’s covered. This Prescription Drug List (PDL) is accurate as of Jan. 1, 2021 and is subject to change after this date. OptumRx is an affiliate of UnitedHealthcare Insurance Company. No matter what, it’s helpful to know how your benefits work. It’s a list of medications and how they’re covered by your plan. 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. Your privacy is important to us! 20PPOSB-315-2 Page 3 of 6 UnitedHealthcare StudentResources maximums and Copays as described in the plan certificate. 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. 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. At times, a similar drug can work just as well — like if there’s a generic version of the drug. 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. 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. Call the phone number on your health plan ID card. UMR is a UnitedHealthcare company. Student Health Insurance Administration. But the Plan pays more — and you pay less — when you use UHCSR Preferred (PPO) doctors. Have questions about your UnitedHealthcare member identification (ID) card? Choosing a network pharmacy may help you save on costs. Prescription Drugs: *UnitedHealthcare Pharmacy (UHCP) $15 Copay per prescription for Tier 1 $35 Copay per prescription for Tier 2 $70 Copay per prescription for Tier 3 up to a 31-day supply per prescription (*Mail order Prescription Drugs through UHPS at 2.5 times the retail copay up to a 90 day supply.) You can also view a general list of pharmacies using the OptumRx Pharmacy Network Search. If you have medications you take regularly, watch your PDL and track changes to stay ahead of possible changes in cost. Upon request, you can purchase coverage for your spouse/partner and dependents. Please consult United Healthcare Student Resources for any benefit limitations on prescription drugs, mental health, chiropractic care, ambulatory care, dental accidents, elective abortion, anesthesiology, assistant surgeons and more. Insurance for Graduate Students on an Assistantship This plan is provided to eligible graduate student assistants as a benefit. If you’ve ever needed prescription drugs, you know they can play an important role in keeping you healthy. ... Talk to your UnitedHealthcare representative for more details. It can help you get your prescriptions filled more easily and help you control costs too. Students - Customer Service: 1-800-767-0700 MAIL. The General UnitedHealthcare Plan Directory allows you to search for doctors, clinics and hospitals by selecting from the UnitedHealthcare family of health plans offered. On your prescription benefits, you may see the name OptumRx®, which is UnitedHealthcare’s pharmacy service provider. Labs must register their tests to participate as part of the Genetic and Molecular Lab Testing Notification/Prior Authorization process. Shop AARP Medicare Advantage, Medicare prescription drug, Medicare Supplement Insurance and Medicare Special Needs plans from UnitedHealthcare. Medications used to treat complex or rare conditions that you may need to get from a specialty pharmacy. Worldwide assistance services (medical evacuation and repatriation) UnitedHealthcare Global: Toll-free within the United States: 1-800-527-0218 PharmD and eligibility for pharmacy licensure in MN required; experience in a community pharmacy setting a plus. If the customer has a UnitedHealthcare Student Resources plan, but uses a third-party behavioral health vendor, then StudentResources administration skills have been honed over decades of managing student health insurance plans. 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). Our Drug Cost Estimator lets you see what you can expect to pay for Medicare Part D prescription drugs. Call the phone number on your health plan ID card. Refer to Care Provider Dispute Resolution (CA Delegates OR HMO claims, OR and WA Commercial Plans) section for more information. UnitedHealthcare, River Valley, Oxford, and Student Resources medical plans with a pharmacy benefit subject to the Traditional 3-Tier PDL. You can ask about a lower cost alternative if the drug your doctor chooses is too expensive or isn’t covered. If you don’t use a participating network pharmacy, you may have to pay the full retail price for your prescriptions. Some medications have quantity limits for quality and safety reasons. They represent a portion of the resources used to support UnitedHealthcare … Want to access your card online? By that time it … Starting Nov. 1, 2017, notification is required for certain genetic and molecular lab tests for certain UnitedHealthcare Commercial benefit plans. $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 It describes benefits we offer to all members in all states. The information is a summary and is subject to change, as of December 12, 2020. Your estimated coverage and copayment/coinsurance may vary based on the benefit plan you choose and the effective date of the plan. Your customized benefits are supported by our flexibility - unique Student Health Center billings, pharmacy claims, referral requirements and customized administrative reports. PDLs may change. Fringe Benefits: 12 days paid time off (includes sick and vacation leave). A Prescription Drug List (PDL) – also called a formulary – is a list of commonly used medications, organized into cost levels, called tiers. This directory includes care providers who serve our Commercial, Medicaid / Community Plan (excludes United Healthcare Community Plan of Rhode Island ) and Medicare members. To better understand the procedures and protocols we follow to help to ensure your privacy, please review the following information: 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. At UMR, we are very sensitive to privacy issues. Try it now to understand your coverage options. If you need to seek medical care or get a prescription before you receive your insurance card, please … Find a Pharmacy Find a Dentist. Student health plans can be a valuable solution for college-bound students and their families. A second-year specialty residency will be considered for individuals who have completed a general practice residency (with stipend adjustment). Let’s walk through some tips on how to use your pharmacy benefits for prescription drugs. Learn about our prescription benefits and health networks now. You can sign in to your health plan account and look under your pharmacy and prescription coverage information to see your plan’s PDL. The Student Health Insurance Plan is provided through UnitedHealthcare Student Resources (UHCSR). OptumRx may be included in your health plan benefits because it offers members coverage through a large network of retail chain and independent pharmacies, as well as through its mail service pharmacy known as OptumRx Home Delivery and the Optum Specialty Pharmacy. If you are subject to a pre-existing condition investigation, please contact the United Healthcare Student Resources directly with questions: (800) 996-4698 or ww… You’ll find the detail about most prescription drug benefits by looking at your plan’s Prescription Drug List (PDL), also called a Formulary. When your doctor prescribes medication, look at your list and talk about the cost. Ordering care providers will complete the notification/prior authorization process online or over the phone. Box 809025 Dallas, TX 75380-9025 Phone: 1-866-948-8472 Email: GKClaims@uhcsr.com Website: www.uhcsr.com. Claim Reconsideration and Appeals Process. Plan Administration UnitedHealthcare StudentResources 2301 West Plano Parkway, Suite 300 Plano, TX 75075 Mail your claims to: UnitedHealthcare StudentResources P.O. A referral from a Student Health Care Center provider may be necessary when using the UF insurance plan. Get information on lower-cost prescription alternatives, if available, to help save members money. With some plans, you have the choice to fill your prescriptions at a participating network pharmacy or with home delivery by mail. ©2020 United HealthCare Services, Inc. Careers - Opens in a new window. These costs are decided by your employer or health plan. The largest amount of medication your plan will cover per copayment or period of time. Lost your member ID card? Claim reconsideration does not apply to some states based on applicable state law. You can view list of pharmacies for your plan by signing in to your health plan account. Find a local pharmacy that's convenient for you. UnitedHealthcare's pharmacy programs allow you to get the medication you need at a low cost. No Benefits Find a local dentist or dental care in your area. You may also view a general PDL, but you’ll need to confirm your specific coverage details before filling a prescription. Prescription Drugs Prescription Drugs covered under the Preventive Care Services benefit will be paid at the benefit levels shown under Preventive Care … UnitedHealthcare Student Resources: UnitedHealthcare Student Resources P.O. A requirement that your doctor explains why you need a certain medication before your plan decides how and if it will be covered. You can use the app to: Here are a few ideas that may help you save on your medications. Prescription Drugs Mail order through UHCP at 2.5 times the retail Copayment up to a 90-day supply. When your plan requires you to try one or more medications before approving coverage for a different one. UnitedHealthcare members with health plans through an employer may use the UnitedHealthcare app to help manage their medications. We are health enthusiasts providing affordable and reliable health insurance, excellent customer service, and … Student Medicover is committed to attacking the greatest healthcare challenges for international students – inflated prices, confusing terms, and complicated processes. If your prescription medication benefit includes home delivery, you can avoid monthly trips to the pharmacy and you may save money too. Your 2020 Prescription Drug List Traditional 3-Tier Effective Jan. 1, 2020 Maybe you take regular medications — or maybe you’ve only needed medication for specific treatments. This PDL applies to members of our UnitedHealthcare and Student Resources medical plans with a pharmacy benefit subject to the Traditional 4-Tier PDL. Doctors: You may receive care from any doctor or hospital. 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