Page 12 - 2019 CommScope
P. 12
Prior Authorization Specialty Pharmacy
Before UHC will cover your prescription, they will want A specialty medication is used to treat complex,
to make sure the medication you are prescribed is long-term conditions that require additional care
medically necessary and appropriate for your situation. and support. BriovaRx®, the OptumRx® specialty
If you don’t receive prior authorization, a medication pharmacy, offers support to help you manage your
may cost you more, or it may not be covered. If condition. Take advantage of personalized patient
medical necessity is required, the provider submits a support at no charge to you from knowledgeable
request via phone, fax or online to: OptumRx Prior pharmacists and nurses who specialize in your
Authorization Department. You or your pharmacy can condition. If you currently have a specialty medication,
also initiate a medical necessity request and OptumRx this will not automatically be transferred to OptumRx
will obtain clinical information from the provider. At this specialty pharmacy. You may choose to have your
point, your request can either be approved or denied. specialty medication transferred to BriovaRx after
If approved, you will be notiied and be able to ill January 1, 2019, call BriovaRx at 855.427.4682. You
your prescription can also register online through the U.S. employee
beneits website and link to the UHC homepage
If denied, you and your provider will be notiied and or at www.briovarx.com/newpatient. BriovaRx
you are able to appeal this decision. Your provider representatives will contact your doctor and take care
will discuss alternative treatment options with you; of everything else.
you can still obtain your prescription; however, it will Refill and Save (on Qualifying Medications)!
likely be at a higher cost
Home Delivery If you reill your prescription for a qualifying medication
(Advair , Breo Ellipta and Symbicort ), you are
®
®
®
OptumRx home delivery is a convenient, cost-effective given $20 in savings off your usual copayment or co-
and safe option for medications you take regularly. This insurance. If you reill your prescription by mail order,
program allows medications to be delivered directly to you will receive a reduction of $50 on your copayment
your door, which means fewer trips to the pharmacy. based on a 90-day supply. You don’t have to sign up or
You also receive up to a 90-day supply, which may save complete a rebate form—you just reill and save.
you money. To begin home delivery, submit your order Half Tablet
online, through the app, or by phone or mail. Once
set up, pharmacists are available by phone 24 hours a The half tablet program is another way to reduce cost.
day, 7 days a week to answer questions. You can set up This program allows you to split your pills and save
automatic reminders to help you remember when to money in the process. Through this voluntary program,
take your medication and reill your prescription. ask your doctor to write a new prescription for twice
the strength and half the quantity; noting your intent
to split the tablets. A new prescription will be illed
automatically paying half your usual cost.
12 ANNUAL ENROLLMENT GUIDE BENEFITS 2019
Before UHC will cover your prescription, they will want A specialty medication is used to treat complex,
to make sure the medication you are prescribed is long-term conditions that require additional care
medically necessary and appropriate for your situation. and support. BriovaRx®, the OptumRx® specialty
If you don’t receive prior authorization, a medication pharmacy, offers support to help you manage your
may cost you more, or it may not be covered. If condition. Take advantage of personalized patient
medical necessity is required, the provider submits a support at no charge to you from knowledgeable
request via phone, fax or online to: OptumRx Prior pharmacists and nurses who specialize in your
Authorization Department. You or your pharmacy can condition. If you currently have a specialty medication,
also initiate a medical necessity request and OptumRx this will not automatically be transferred to OptumRx
will obtain clinical information from the provider. At this specialty pharmacy. You may choose to have your
point, your request can either be approved or denied. specialty medication transferred to BriovaRx after
If approved, you will be notiied and be able to ill January 1, 2019, call BriovaRx at 855.427.4682. You
your prescription can also register online through the U.S. employee
beneits website and link to the UHC homepage
If denied, you and your provider will be notiied and or at www.briovarx.com/newpatient. BriovaRx
you are able to appeal this decision. Your provider representatives will contact your doctor and take care
will discuss alternative treatment options with you; of everything else.
you can still obtain your prescription; however, it will Refill and Save (on Qualifying Medications)!
likely be at a higher cost
Home Delivery If you reill your prescription for a qualifying medication
(Advair , Breo Ellipta and Symbicort ), you are
®
®
®
OptumRx home delivery is a convenient, cost-effective given $20 in savings off your usual copayment or co-
and safe option for medications you take regularly. This insurance. If you reill your prescription by mail order,
program allows medications to be delivered directly to you will receive a reduction of $50 on your copayment
your door, which means fewer trips to the pharmacy. based on a 90-day supply. You don’t have to sign up or
You also receive up to a 90-day supply, which may save complete a rebate form—you just reill and save.
you money. To begin home delivery, submit your order Half Tablet
online, through the app, or by phone or mail. Once
set up, pharmacists are available by phone 24 hours a The half tablet program is another way to reduce cost.
day, 7 days a week to answer questions. You can set up This program allows you to split your pills and save
automatic reminders to help you remember when to money in the process. Through this voluntary program,
take your medication and reill your prescription. ask your doctor to write a new prescription for twice
the strength and half the quantity; noting your intent
to split the tablets. A new prescription will be illed
automatically paying half your usual cost.
12 ANNUAL ENROLLMENT GUIDE BENEFITS 2019
