Welcome to Optum Rx

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New for 2024 Basic/Commercial Home Delivery Maintenance Program

Reproductive and Preventive Health Pharmacy Benefits

Optum Rx is pleased to be your Pharmacy Benefit Manager (PBM) providing prescription benefits for the CalPERS health plans listed below.

Our PBM services include:

Administration of the Retail Pharmacy Network and Home Delivery Programs
Delivery of Specialty Pharmacy products, including injectable Medications
Clinical pharmacist consultation
Clinical collaboration with your physician to ensure you receive optimal total healthcare

We look forward to helping you on a path to better health.

View changes to your medication

See how your costs and coverage may change.

Find a network pharmacy

Locate in network pharmacies near you.

Prescription drug list

Search your plan's formulary or prescription drug list to find covered products and additional details.

Your pharmacy network

The pharmacy network includes access to thousands of retail locations, including large, national chains and many community pharmacies. For medications you take regularly, you can also use the OptumRx home delivery pharmacy.

Find a network pharmacy

Your prescription drug benefits

Working with CalPERS, OptumRx provides convenient and flexible options for the prescription drugs you and your family may need. We are here to guide you through the open enrollment process and to help you understand your plan options, so that you can save time and money when your benefits plan starts.

Formulary drug list
Pricing and coverage tool

Health Care Reform (PDF)*
Vaccine FAQ (PDF)

Get more information about Covid-19 test Kits, including reimbursement:
Basic and Medicare

Evidence of Coverage

Deterra Kit Information

OptumRx promotes ways to safely dispose of your medications at no charge to you. Check with your local pharmacy kiosk or call the number on the back of your Plan ID card 24 hours a day, seven days a week to request a free Deterra Kit.

Introducing Deterra
Deterra Drug Deactivation System
Deterra is the Solution
Deterra FAQ

Plan Highlights

Anthem Blue Cross
UnitedHealthcare
HealthNet
WesternHealth Advantage
Sharp Health Plan
Blue Shield of CA PPO
Included Health PPO

Contact Us

Basic Members: 1-855-505-8110
Medicare Part D Members: 1-855-505-8106
Members needing TTY service: please dial 711

Forms

Non-Medicare Prior Authorization Forms for Healthcare Professionals
Medicare Prior Authorization Forms for Healthcare Professionals
Claim form commercial, PPO and union

Resources

Frequently Asked Questions
Basic Coverage Determination Process
Prior Authorization Information
Medicare Part B Diabetic Supply Info
Medicare Coverage Determination Process
Medicare Redetermination & Appeals Process
Mobile App Flyer

Formularies

* The Medicare Part D Prescription Drug Plan (PDP), is sponsored by CalPERS, administered by OptumRx, and offered in conjunction with the Anthem Medicare Preferred medical plan.

How-To videos

Who is Optum Rx?
Optum Rx online tools
What is Prior Authorization?
What is a formulary?
What is home delivery?