You and your doctor can use the formulary to help you choose the most cost-effective prescription medications. This guide tells you if a medication is generic or brand, and if special rules apply.

This is a list of biannual tier changes made to your formulary. Each medication is placed in a tier that shows the cost level you may pay for that prescription.

Jul 1, 2025 · Certain states require Optum Rx to communicate prior authorization changes before the effective date. Flyers are sent to members to outline the drugs affected by prior …

To create the list, Optum Rx® is guided by the Pharmacy and Therapeutics Committee. This group of doctors and pharmacists reviews which medications will be covered, how well the …

You and your doctor can use the formulary to help you choose the most cost-effective prescription medications. This guide tells you if a medication is generic or brand, and if special rules apply.

Jan. 1, 2026 Optum Rx® Vigilant Drug Strategy updates Removing waste and shifting use to lower cost drugs through exclusions Additions

A formulary is a list of prescribed medications or other pharmacy care products, services or supplies chosen for their safety, cost, and effectiveness. Medications are listed by categories …

Jan. 1, 2026 Premium Formulary Exclusions & Preferred Specialty Prior Authorization Requirements

You can access the OptumRx premium formulary reference guide here.

Find an Optum Rx network pharmacy near you. See what drugs your plan covers, and if you have a deductible for prescriptions, use the Drug Pricing Tool to learn how much your drugs may …