Pharmacy Benefits FAQs
Learn more about coverage, pricing, Optum Home Delivery, Optum Specialty Pharmacy, and prior authorization under the Compass Rose Health Plans.
To learn if your medication is covered and view pricing under the Standard or High Option Plans, please visit compassrosebenefits.com/optumrx. You may also log in to optumrx.com to check your plan’s formulary.
To learn if your medication is covered and view pricing under Compass Rose Medicare Advantage, please visit retiree.uhc.com/compassrose.
To learn if your medication is covered and view pricing under the Standard or High Option Plans, please visit compassrosebenefits.com/optumrx. You may also log in to optumrx.com or myCompass.
To learn if your medication is covered and view pricing under Compass Rose Medicare Advantage, please visit retiree.uhc.com/compassrose.
There are several ways to place a home delivery order:
- Go online to optumrx.com, download the Optum Rx app or contact Optum Rx by phone at (800) 557-5785.
- Your doctor can send an electronic prescription to Optum Home Delivery. Prescriptions for controlled substances, such as opioids, can only be ordered by e-prescribe.
No, you do not need to pay for shipping. Standard shipping with order tracking is free on all Optum® Home Delivery orders. After your prescriber or pharmacy sends your prescription, your medication should arrive at your door within 3-5 business days. Medications are shipped securely to you with puncture-resistant and tamper-evident packaging to keep your information private. All temperature-controlled medications are shipped according to the manufacturer’s guidelines in order to maintain their optimal temperature range.
Specialty medications are for conditions such as cancer, multiple sclerosis, and rheumatoid arthritis. They can be injectable, taken by mouth or inhaled. They also:
- May require ongoing clinical oversight and additional education for best management.
- Have unique storage or shipping requirements.
- May not be available at retail pharmacies.
To learn more about specialty services:
- Visit specialty.optumrx.com/new-fill. Optum Specialty Pharmacy will contact your doctor and take care of everything else.
- Call a specialty representative at (866) 306-8900
- Text NEW to 55455 to get started with Optum Specialty Pharmacy**
Some medications may need prior authorization to ensure you receive medications that are safe, effective, and provide the greatest value. If your medication needs prior authorization, your provider will need to let us know why you are taking the medication to determine if it will be covered under your pharmacy benefit.
You may call Optum Rx at (888) 438-9135 or go to compassrosebenefits.com/optumrx and click on Prescription drug list to confirm if your medication requires a prior authorization.
Beginning in 2025, members entitled to Medicare Part A and/or enrolled in Medicare Part B and not currently enrolled in the Compass Rose Medicare Advantage Plan will be automatically enrolled in the Compass Rose Medicare PDP EGWP.
You'll pay lower out-of-pocket costs under each drug tier and have separate out-of-pocket maximums for medical and pharmacy costs. Plus, the Compass Rose Medicare PDP EGWP allows you to get a 90-day supply of medications at any network retail pharmacy, in addition to CVS and Walgreens.
