2022 Archdiocese of Atlanta / Lay Employee Quick Guide - Flipbook - Page 12
Your plan includes prescription drug benefits
Your prescription benefits are administered by OptumRx
OptumRx Member Services
• 1-855-896-9779, 24 hours a day, seven days a week.
• Via the OptumRx website: www.OptumRX.com. You can also manage your home delivery
Prescription drug co-payments
Your prescription co-pay will depend on whether your medication is a generic or brand name drug. Generic
drugs have the lowest co-pays; brand name co-pays are higher.
▪ Not all classes of medication are covered by your plan.
▪ All over-the-counter medications are excluded as well as drugs used for
▪ Other drugs may also be excluded.
▪ Contact OptumRx, or refer to your plan document for additional information.
Prior authorization is required for certain drugs.
• Some prescription drugs require prior authorization. Prior authorization is used to manage prescriptions
that are very expensive or have the potential for inappropriate use. For more information, refer to your plan
document or contact OptumRx at 1-855-896-9779.
• To obtain prior authorization, your doctor must call OptumRx and provide a letter of medical necessity:
You have two purchase options.
Retail pharmacy- When you need a prescription for 30 days or less, take it to a participating pharmacy
or ask your physician’s office to call the prescription in. At the pharmacy, present your Archdiocese
Health ID card and make the appropriate co-payment.
OptumRx Home Delivery – OptumRx Home Delivery Program is designed for plan participants taking
maintenance medications, or those medications taken on a regular basis, for the treatment of long-term
conditions such as diabetes, arthritis or heart conditions. The program provides up to a 90- day supply
of medication, delivered directly to your home or other requested location, postage paid.
In order to fill your prescription through the OptumRx Home Delivery Program, mail your prescription,
order form and payment directly to OptumRx. You may also ask your doctor to fax your prescription
by calling 1-855-896-9779 for further instruction, or they can send an electronic prescription to