OptumRx Pharmacy Benefits
OptumRx acts as the Pharmacy Benefit Manager for a majority of CalPERS health plans. OptumRx replaced CVS/Caremark on January 1, 2017 in administering prescription drug benefits for about 632,000 CalPERS members and their families.
The following health plans feature OptumRx:
- PERS Gold & PERS Platinum PPO plans (Basic and Medicare Supplement)
- Anthem Blue Cross EPO, Traditional & Select HMOs
- Anthem Blue Cross Monterey & Del Norte EPOs
- Health Net SmartCare & Salud y Más
- Sharp Health Plan Performance Plus
- UnitedHealthcare SignatureValue Alliance & Signature Value Harmony
- Western Health Advantage HMO
Blue Shield of California, Kaiser Permanente, and UnitedHealthcare Group Medicare Advantage PPO health plans were not affected.
Members can take advantage of OptumRx benefits that include:
- Home delivery and Preferred90 retail pharmacy program; receive up to a three-month supply on maintenance medication for two copayments.
- Access to large national chain and local pharmacies.
- Up to a three-month supply on maintenance medication for three copayments at a participating pharmacy other than home delivery or a Preferred90 retail pharmacy.
- Online account management.
Your health plan's pharmacy copayments for will remain the same, however, some drug coverage and cost share may be different, which could impact your out-of-pocket cost.
For more information about OptumRx, visit the OptumRx website.