Consumer Driven Option pharmacy benefits for our federal plans

OptumRx provides pharmacy benefits for the Consumer Driven Option. The network features more than 67,000 pharmacies, including large national chains, local community pharmacies, home delivery, and specialty.

Coverage for retail and mail-order prescriptions

Consumer Driven Option prescription coverage

Network retail

Tier 1/Tier 2

Lower cost/Mid-range cost

Tier 3

Highest cost

In-network you pay

25% ($15 min/$200 max) for a 30-day supply per Rx

$400 for a 60-day supply per Rx

$600 for a 90-day supply per Rx

40% ($15 min/$300 max) for a 30-day supply per Rx

$600 for a 60-day supply per Rx

$900 for a 90-day supply per Rx

Network home delivery

Tier 1/Tier 2

Lower cost/Mid-range cost

Tier 3

Highest cost

25% ($10 min/$200 max) for a 30-day supply per Rx

$400 for a 60-day supply per Rx

$600 for a 90-day supply per Rx

40% ($10 min/$300 max) for a 30-day supply per Rx

$600 for a 60-day supply per Rx

$900 for a 90-day supply per Rx

Calculate the cost of your medications

Visit the OptumRX drug pricing tool.

During your deductible phase, members are responsible for the total cost of medication.

Prescription drug list

Search the plan’s formulary or prescription drug list to find covered products and additional details.

Your prescription drugs are covered 100%

Your Personal Care Account (PCA) covers 100% of eligible expenses, including prescription drugs. If you fill a prescription when you have benefit dollars available in your PCA, the funds will be applied, and you’ll pay nothing.

Save money on your prescriptions

Receive a discount when you use OptumRx Home Delivery. When you order or refill a prescription by mail, the discounted cost of the medication will be subtracted from your PCA.