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Understand why you may need prior authorization
• Certain medications may require additional approval, or prior authorization, from Independence before you can receive them.
• Prior authorization helps ensure you receive safe and affordable access to covered medications.
• Some reasons you may need prior authorization for a drug are due to:
Ɍ Limits based on a person’s age
Ɍ Limits on the quantity (amount) that can be prescribed
at one time.
• Visit ibx.com/precert to view a list of medications that require prior authorization.
Simplify and save with mail order and 90-day supply prescriptions
• If you’re taking a medication long term, you can save time by ordering up to a 90-day supply at participating in-network pharmacies or through mail order. There is no cost for delivery.
Specialty pharmacies
• If you are prescribed a specialty or infusion medication, you can receive care at a Optum Specialty Pharmacy or at a Optum Infusion Pharmacy.
Coverage for COVID-19 vaccines and over-the-counter test kits
It’s important now more than ever to protect yourself and others from COVID-19. You can receive your COVID-19 vaccine at your doctor’s office, a retail health clinic, or at the pharmacy counter and pay nothing out of pocket. You can also obtain up to eight over-the-counter COVID-19 test kits per calendar month at no cost when you show your member ID card at a Rite Aid, Walmart, or Sam’s Club pharmacy counter.
Over-the-counter COVID-19 test kits can also be purchased online through the OptumRx store. Log in to your member account at ibx.com, select Pharmacy in the My Benefits box, scroll down and select Pharmacy Mail Order/ Home Delivery.
A new page will open. If you have not accessed the Pharmacy Mail Order/Home Delivery function previously, you may be required to register your account. From there, select Order Now to get at-home COVID-19 tests with $0 copay. Please note that there is a minimum order amount required to get free shipping. Log in now.
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