Welcome to CoverKids

Welcome to the OptumRx and CoverKids website where you can find information to meet your pharmacy needs. The CoverKids program is for those children 18 years old or younger and pregnant women who don’t have insurance and who don’t qualify for TennCare.

May 20, 2024: Please check back for updates regarding TennCare’s diaper benefits launching this summer. 

Please visit www.tn.gov/tenncare/diapers for information on the TennCare and CoverKids diaper benefit.

Effective July 1, 2023, Public Chapter 1 places prohibitions on healthcare providers regarding the performance or administration of medical procedures related to specific medical conditions. These prohibitions will require changes in (Optum/BlueCare/United Healthcare/AmeriGroup) prior authorization processes. More detail about these process changes will be provided prior to July 1, 2023. The text of this new legislation can be found on the Tennessee Secretary of State website at: pc0001.pdf.(tnsosfiles.com).

Provider Login

Providers can login to CoverMyMeds to access features like Web PA for prescribers and Web RA for pharmacies.

Covermymeds.com

Prescriber

As the main caregiver of our member’s health, OptumRx is excited to partner with you on educating and providing care for our members. Here you will find important Program Information, Prior Authorization Forms, Clinical Criteria and all Prescriber Communications needed to provide an overall continuity of care.

Important Update: Due to recent shortages of albuterol HFA products, the following products will be changed to preferred status on the CoverKids formulary: ProAir HFA, ProAir Respiclick, and Ventolin HFA.

Clinical Criteria and CoverKids Formulary

Prescriber Prescriber Communications

Prior Authorization/Appeals forms

Related Links:

TennCare

CoverRx

Pharmacist

OptumRx looks forward to partnering with our Pharmacists in providing quality pharmacy services to our members. Here you will find how to enroll and become a CoverKids Pharmacist, Program Information, Clinical Criteria, Patient Forms and all Pharmacy Communications.

Please use Google Chrome, Microsoft Edge, or Firefox as your browser to access the files on the TennCare site. Other browsers like Internet Explorer cause issues with functionality and links between files. 

May 20, 2024: Please check back for updates regarding TennCare’s diaper benefits launching this summer.

Pharmacist Communications

Clinical Criteria and CoverKids Formulary

Provider Manual

Enrollee

As a member of CoverKids, OptumRx is here to help with your pharmacy needs. Here you can find participating pharmacy, order a replacement ID card and much more.

We obey federal and state civil rights laws. We do not treat people in a different way because of their race, color, national origin, language, age, disability, religion, or sex. Do you think we did not help you or you were treated differently because of your race, color, national origin, language, age, disability, religion, or sex? To report different treatment to TennCare find more information at: https://www.tn.gov/tenncare/members-applicants/civil-rights-compliance.html or email: HCFA.fairtreatment@tn.gov.

Important Update: Due to recent shortages of albuterol HFA products, the following products will be changed to preferred status on the CoverKids formulary: ProAir HFA, ProAir Respiclick, and Ventolin HFA.

Enrollee Forms

Find a Network Pharmacy

CoverKids Formulary

Related Links:

TennCare

CoverRx