Welcome to TennCare
Welcome to the Optum Rx and TennCare website, where you can find information to meet your pharmacy needs.
NEW TennCare Pharmacy Updates Newsletter click here to subscribe.
Please visit www.tn.gov/tenncare/diapers for information on the TennCare and CoverKids diaper benefit.
TennCare-Cost of Dispensing Survey Final Report Summary
Provider Login
Providers can login to CoverMyMeds to access features like Web PA for prescribers and Web RA for pharmacies.
Useful Links
Report Fraud and Abuse
Report Provider Fraud >
Preferred Drug List
TennCare PDL >
Criteria PDL >
Interim Criteria for Agents Awaiting PAC Review >
*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.
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.
NEW TennCare Pharmacy Updates Newsletter click here to subscribe.
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.
2023 BESMART Virtual Education
Clinical Criteria and Preferred Drug List
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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 TennCare Pharmacist, Program Information, Clinical Criteria, Patient Forms and all Pharmacy Communications.
NEW TennCare Pharmacy Updates Newsletter click here to subscribe.
Please visit www.tn.gov/tenncare/diapers for information on the TennCare and CoverKids diaper benefit. To highlight your pharmacy or remove your pharmacy from the list of pharmacies that provide diapers provided to members, please complete this survey: https://forms.office.com/r/3BcAP6hLT7
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.
Clinical Criteria and Preferred Drug List
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Mercer Dispense Fee Survey and Webinars >
Enrollee
As a member of TennCare, 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.
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Drug Utilization Review (DUR) Board Committee
OptumRx is excited to participate and facilitate the Drug Utilization Review (DUR) Board meetings. On this page find DUR Board members, as well as Agendas, Presentations and Minutes from previous meetings
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Pharmacy Advisory Committee (PAC)
OptumRx is excited to participate and facilitate the Pharmacy Advisory Committee (PAC) meetings. On this page find PAC Members as well Agendas, Presentations and Minutes from previous meetings.
TennCare Industry Day Presentations
Please click here to learn more and register for a time slot.
The next Pharmacy Advisory Committee (PAC) meeting is scheduled for Thursday, November 7, 2024, 9:30 am CST – 3:30 pm CST and will be VIRTUAL ONLY.
Meeting Phone Number and Conference ID: 1 952-222-7450, 544 252 803#
To access the meeting: Microsoft Teams Meeting: Click here to join the meeting
Drug class quarterly review schedules
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