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1-100: Maintenance Rx Mail Order Begins July 2016 – Opt Out Required

Apr 27, 2016

Beginning July 1, 2016 at renewal, the Mail Service Member Select pharmacy program takes effect for fully insured commercial (1-100) group members in California. This program helps UnitedHealthcare members better manage the medication they take regularly by encouraging them to use OptumRx® Mail Service Pharmacy. 

Members are automatically enrolled in the program if they are prescribed certain maintenance medications. They may choose to transfer their prescription(s) to the Mail Service pharmacy or opt out and continue filling these prescriptions at a retail pharmacy. If they take no action, they may be responsible for 100% of the cost of the maintenance medication. 

Advanced Notification for Existing Groups
Members with eligible Maintenance Medications will receive a personalized letter at least 60 days in advance of the Plan effective date. This letter will include information about the program, how to transfer prescriptions to the Mail Service pharmacy OR how to opt out and continue filling their prescriptions for these maintenance medications at a retail pharmacy. 

Member Communications for All Groups
Members of new groups or with new eligible prescription(s) will receive similar information by mail after the initial fill of a qualifying maintenance medication at a retail pharmacy.  After the second retail fill, they will be notified by mail again that a decision needs to be made. Retail Point-of-Sale (POS) messaging is also provided directing members to contact Customer Service. 

If members do not enroll in the mail service program or opt out after the second fill, they will be responsible for 100% of the cost of the maintenance medication. Members may opt-out of Mail Service through the website at myuhc.com or by calling Customer Service.

The mail service pharmacy provides many member benefits, including:

UnitedHealthcare will notify Small Business clients of this change through standard renewal packets.

For questions, please ​contact a member of your b&p Sales Team - 888.722.3373.

OptumRx is the Pharmacy Benefit Manager for members. 

This information applies to fully insured commercial group employers in California who offer their employees a benefit plan that includes pharmacy coverage and is effective on or after July 1, 2016. 

Mail Service Member Select does not apply to drugs in the Specialty medication program.

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