Welcome to OptumRx, Harvard Pilgrim's Pharmacy Benefit Manager (PBM)
Harvard Pilgrim partners with a Pharmacy Benefit Manager (PBM) to administer the pharmacy benefit for our Medicare Advantage Stride℠ HMO/HMO-POS plans. Our PBM, among other things, facilitates the processing of claims at the pharmacy. Use OptumRx's tools to find a pharmacy, search our formulary (prescription drug list) and get drug pricing. To return to the Harvard Pilgrim website, click here.
Your 2025 pharmacy network
The pharmacy network includes 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.
To get started with OptumRx home delivery, visit optumrx.com or call 855-524-0380. Be sure to have your Harvard Pilgrim ID number, prescription number(s) and credit card information ready when you call.
Your 2025 prescription drug benefits
Search the prescription drug list below to find out if, and how, your drug is covered. The drug list includes the tier on which the drug is covered, plus any requirements or limits on its coverage including prior authorization and step therapy.
To check the price of a drug in the initial coverage limit stage, after meeting your deductible, use the drug pricing tool. Please note, if the drug requires prior authorization, pricing will not be available. If you are already a member, you can log into your Harvard Pilgrim account to get real-time pricing information, including if a drug requires prior authorization.
Prescription drug list
Drug Pricing Tool
2025 Harvard Pilgrim Health Care Stride℠ HMO/HMO-POS formulary
Harvard Pilgrim is an HMO/HMO-POS plan with a Medicare contract. Enrollment in Stride℠ (HMO/HMO-POS) depends on contract renewal.
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The information on this page was last updated on 10/1/2023.