Prescription Drug Coverage

When you sign up for a UMR health plan, you receive prescription drug benefits through OptumRx. Bring your UMR ID card when you visit a pharmacy. Most major pharmacies and neighborhood pharmacies are part of the OptumRx network.

Except on the Platinum plan, you pay the full cost of your prescriptions (often at a discounted rate with insurance) until you meet your health deductible. Prescriptions are then covered by a co-payment.

To manage your pharmacy benefits and find in-network pharmacies with OptumRx, log into UMR.com, and select Pharmacy.

► Print or request an ID card, and view your prescription history.
► Search for drug pricing and lower-cost alternatives
► Refill and renew mail service pharmacy prescriptions
► Transfer your retail prescriptions to our mail service pharmacy
► View your mail service order status and claim history
► Sign up for medication reminders via text message
► View your OptumRx benefits in real time

If you are visiting an out-of-network pharmacy, your prescriptions may cost you more or may not be covered at all.

Mobile website
Use your smartphone to access OptumRx’s mobile website where you can:

► Request prescription refills
► Check order status
► Locate a retail pharmacy
► Search your plan’s formulary

Register via our mobile website OptumRx

Maintenance Medications
When you fill your prescription more than two times, you’ll be required to fill it through Mail Order with OptumRx. Once you’ve met your deductible (and right away on the Platinum plan), you’ll receive three months supply for the cost of two months.

Prescription Benefits Cost of Coverage

Bronze Silver (HSA) Gold (HSA) Platinum
Bronze Silver (HSA) Gold (HSA) Platinum
Prescriptions
Tier 1 (Generic)
Tier 2 (Brand)
Tier 3 (Non-preferred)
Tier 4 (Specialty)
Deductible applies, once deductible is met, then copay applies Deductible applies, once deductible is met, then copay applies Deductible applies, once deductible is met, then copay applies $10
$35
$60
$75
OptumRx-Home Delivery
OptumRx-Find a Pharmacy
OptumRx
Quick Reference Guide
OptumRx Home Delivery
Premium Formulary Exclusion List January 2024
OptumRx Formulary January 2024

Video: Prescription Drug Benefits

Video: Managing RX Costs