Prescription Drug
If you are an eligible Active member, Retiree, spouse or child, you can get prescription drugs exclusively through OPTUMRx by mail or from a OPTUMRx Network Pharmacy. OPTUMRx includes about 80 percent of the pharmacies in Connecticut and nationwide.
The prescription drug Plan utilizes a three tiered co-pay system, which applies the lowest fees to generic drugs, the next lowest to formulary drugs for which OPTUMRx provides preferential pricing, and the highest for brand name drugs not included in the formulary.
Specialty Drugs: Specialty drugs are specialized drug therapies developed for chronic, complex illnesses that require special handling and are often administered via injection. Such drugs are often prescribed for treatment of cancer and multiple sclerosis and cannot be obtained through our retail pharmacy network. Instead, they must be ordered through OPTUMRx by calling toll free 1-855-427-4682.
Effective 1/1/2022 the Plan is utilizing the following OPTUMRx Programs
To locate a OptumRx pharmacy, call toll-free 855-295-9140 or visit their Web site at www.optumrx.com
Effective 1/1/2022 the Plan is utilizing the following OPTUMRx Programs
To locate a OptumRx pharmacy, call toll-free 855-295-9140 or visit their Web site at www.optumrx.com
| Retail Pharmacy - 30 day supply* | Mail-Order - 90 days (3 months) supply* |
| Generic Co-payment - lesser of drug cost or $15 | Generic Co-payment - lesser of drug cost or $25 |
| Brand (Formulary) Co-payment - lesser of drug cost or $30 | Brand (Formulary) Co-payment - lesser of drug cost or $55 |
| Brand (Non-Formulary) Co-payment - lesser of drug cost or $45 | Brand (Non-Formulary) Co-payment - lesser of drug cost or $85 |