A Prescription Drug List (PDL) - also called a formulary - is a list of commonly used medications, organized into cost levels, called tiers. . 0000085711 00000 n 0000119904 00000 n >!gV{ endstream endobj startxref 0000172253 00000 n 0000061089 00000 n 0000060865 00000 n Medications are listed by therapeutic category. HVj0}WXe$Ats4(}!& A^%q JZsf'jf?&X-.dx|lovw,le98Azo-]u\;dEw]7+dn*3l\}S[H(,hu9BQVShNs;|TdYeSplRph.R$COLKKw-I5_esb_)b5#&D#vO9I_JD&VHrF:%_ kP1 b ll`y*1BAD`dfC/ u}@V,8%)?OVRKfy{ pP.8AH2(DZ:ME CIi9e{V'='E%QUk2zi`]li]"moi"ffj(dllD,]Wld,cYB^Z 5l[[e1cFo ]A1Rg\ g']:Q$h{|BN?%4aNhDON>j29%39'f]Eb9QT:3u5jMSmu5jYWVk@C wZ9[8Y/^bm+ tq endstream endobj 1953 0 obj <> endobj 1954 0 obj <>stream 0000085487 00000 n 0000101027 00000 n 0000174949 00000 n Preventive medications are a group of products in your plan's formulary which Write a review. 0000007149 00000 n 0000177535 00000 n 0000060984 00000 n 0000130550 00000 n If a medication changes tiers, you may have to pay a different amount for that medication. 0000130827 00000 n Your specific plan may not cover all of the drugs. 0000172689 00000 n 0000086125 00000 n 0000006758 00000 n 0000131906 00000 n 2. 2 Existing utilizers of these medications will be allowed to continue on therapy with the diagnosis of HIV only. 0000009888 00000 n 0000155145 00000 n View Updates . asenapine maleate sublingual tablet sublingual CAPLYTA ORAL CAPSULE It may also help you understand plan requirements that may affect your coverage for a medication. Drug list This is a list of specialty medications that Optum Specialty Pharmacy can provide or facilitate access and is subject to change. 0000030955 00000 n 0000101665 00000 n 0000026597 00000 n 0000171816 00000 n Anti-Addiction / Substance Abuse Treatment Agents. INTERMEZZO SUBLINGUAL TABLET SUBLINGUAL 1.75 MG: JADENU. hb```u+( =n k@1|W7xkxHF{Kk>^a`c|w<>|4YZ >@ua`:20 &) 0000007262 00000 n Continuation of therapy will not be provided for any other excluded drugs. 0000114353 00000 n endstream endobj startxref Notes. 0000130747 00000 n Helps you get and maintain an erection when you need it. 0000171319 00000 n Drug list information In this drug list, some medications are noted with letters next to them to help you see which ones may 0001380992 00000 n 0000111956 00000 n 0000100974 00000 n Drug Name. You can use a resource called a prescription drug list (PDL) to check your coverage. 2020 Preventive medications and your plan Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for generic . 0000084968 00000 n 0000027568 00000 n Viewing all, select a filter. 0000085675 00000 n You can also search for a specific prescription medication to find out if it's covered or what you'll have to pay out-of-pocket. 0000027419 00000 n endstream endobj 1937 0 obj <>/Metadata 82 0 R/PageLabels 78 0 R/Pages 81 0 R/StructTreeRoot 84 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1938 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>/Shading<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 1939 0 obj <> endobj 1940 0 obj <> endobj 1941 0 obj <> endobj 1942 0 obj <> endobj 1943 0 obj <> endobj 1944 0 obj <>stream Many new drugs may cost more yet offer no additional health benefit. 0000014395 00000 n PA Prior Authorization - Your doctor is required to give OptumRx more information Drug list information . 0000129399 00000 n {wvstEYy14[gAE:]e7 ><>'zW'[ 0000173205 00000 n 1159 0 obj <>/Filter/FlateDecode/ID[<4803594C7CCAE34D9F026528C692D72F>]/Index[1139 35]/Info 1138 0 R/Length 94/Prev 80948/Root 1140 0 R/Size 1174/Type/XRef/W[1 2 1]>>stream 0000110305 00000 n Your PDL is broken into cost levels called tiers. Tier E Excluded May not be covered or need prior authorization. 0000131791 00000 n 0000176261 00000 n 0001378359 00000 n 0000008070 00000 n For questions on injectable preventive medications administered by your doctor or healthcare 2023 Select Standard Formulary 2023 Select Standard Formulary For the most current list of covered medications or if you have questions: Call the number on your member ID card. 0000008249 00000 n Medications are listed by therapeutic category. Maximum daily dose quantity limits apply. 1. 0001379759 00000 n Go to Pharmacies and Prescriptions to search for a provider list in your area. %%EOF Formulary and drug lists. 0000175387 00000 n Read our specialty pharmacy to learn more. 0001379151 00000 n There are thousands of drugs available today and more coming to market every day. %PDF-1.4 % 0001380633 00000 n 0000173640 00000 n Our goal is to provide members with wide-ranging, cost-effective medication choices. 2021 Preventive Medication List Expanded listing by therapeutic category AGENTS FOR CHEMICAL DEPENDENCY acamprosate calcium buprenorphine sublingual buprenorphine/naloxone ANTIARRHYTHMIC AGENTS amiodarone disopyramide dofetilide flecainide MULTAQ Pacerone propafenone propafenone er sotalol sotalol AF ANTICONVULSANTS They also make sure there are safe and covered options. Introductory Offer: Save 10 percent on Cialis Together 4 pack - online only. hbbd``b`n` When does the formulary change? H\j0~ 0000121674 00000 n Medications are listed by therapeutic category. 0000176182 00000 n Managing your health with preventive medications. 0000035643 00000 n 0000085408 00000 n Generic Versions of certain medications are available. sublingual. 0000130173 00000 n Filter by. 0000132031 00000 n 0000101251 00000 n Below is a list of drugs which are not covered under the Mail Order Program. Your 2020-2021 Formulary Maricopa County OptumRx Coinsurance Prescription Plan . Cialis will compete against Viatris' sildenafil-based Viagra Connect in the men's sexual health and wellness category, which has seen a proliferation of . 0000030876 00000 n 2023 Preventive medications and . We would like to show you a description here but the site won't allow us. 0000174511 00000 n Were always looking for the safest, most effective and lower cost medication to include with your health plans. 0000006909 00000 n 0001380554 00000 n We provide members with the information, tools and support they need to make better health care decisions such as: We also reach out to physicians and pharmacists, so they can guide members through their medication decisions. 3 Brand-name medications are shown in UPPERCASE (for example, CELEA) and generic medications in lowercase (for example, citalopram). 'Xm\Bv&?r*=:!P:Lh((F~sRG&:zWOD*,`v? 0001379230 00000 n 0000020637 00000 n Menu. You can talk with your doctor about your PDL and discuss lower cost options to help you find prescriptions that may work with your budget. 0000131134 00000 n 0000008960 00000 n %%EOF Go to Pharmacies and Prescriptions - Prescription Drug List (PDL) to see a list of medications covered under your plan. 2. 2Q0 endstream endobj 1945 0 obj [/Separation/PANTONE#20284#20C 2017 0 R<>] endobj 1946 0 obj <> endobj 1947 0 obj [/Separation/PANTONE#20541#20C 2017 0 R<>] endobj 1948 0 obj [/Separation/PANTONE#20314#20C 2017 0 R<>] endobj 1949 0 obj <>stream Lower-cost options are available and covered. Exclusions: The following drugs/supplies are excluded: Non-Federal Legend Drugs; Allergy Serum(covered through the medical plan); Medications are listed by therapeutic category. 0000130493 00000 n 0000006606 00000 n 0000130907 00000 n 0000004869 00000 n endstream endobj 1901 0 obj <>/Metadata 61 0 R/Names 1914 0 R/OpenAction 1902 0 R/Outlines 87 0 R/PageMode/UseThumbs/Pages 1896 0 R/StructTreeRoot 122 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1902 0 obj <> endobj 1903 0 obj <. . When you switch to a new plan, your prescription coverage may change. This means you'll pay your copayment/coinsurance or nothing at all, depending . 0000021622 00000 n 0000013307 00000 n You can find prescription medications coverage information for your plan by logging in to OptumRx.com. But, not all drugs are created equal. 0000172768 00000 n Thats why our PDLs promote medications with the greatest health care value, regardless of brand or generic status. These costs are decided by your employer or health plan. 0000131673 00000 n 0i5`]!my;JqM2^=`fQ=F)@hbdrM`QTKhm`Vc/AY#6MQ_dj' )QNEqMUCn&0tJ'[0 0000021964 00000 n Your 2020 Formulary For the most current list of covered medications or if you have questions: Call the number on your member ID card. 0000026969 00000 n A list of covered preventive medications begins on the next page. SORT BY; A-Z; 0000131293 00000 n 0000101215 00000 n Find OptumRx formularies, formulary updates, and drug lists. 0001378867 00000 n A list of covered preventive medications begins on the next page. 0000155104 00000 n You can find a list of network pharmacies on OptumRx.com or by using the mobile app. 7. 0000173996 00000 n Drug Tier. 1173 0 obj <>stream Optum guides providers through important upcoming formulary updates . %PDF-1.7 % Please see your plan's formulary for coverage details. -3&IVc]/#;Qb&(&b` xan4*Yrhj6/S|dG@L@;}'E+7zH?!H`mSaC#y451Y\:d_ ,F'K|Iqp9F ||]lX m7GmjR!nG!}*>2u4 BL@YUTc nOLa,AjEDy(O>+8Or*pp^xvyHGo=TfFE:s's+$9[! S endstream endobj 2104 0 obj <>/Filter/FlateDecode/Index[84 1852]/Length 62/Size 1936/Type/XRef/W[1 1 1]>>stream To help make sure you get the medications you need, check to see if theyre covered at OptumRx.com or in the mobile app. %PDF-1.6 % 0000177056 00000 n Choosing medications in lower tiers may save you money. Was 21.99. 0000020201 00000 n 0001380196 00000 n h1 04u\Gag&`'MF[!! 0001378749 00000 n 0000014949 00000 n Stay up to date on the latest OptumRx information, Arkansas Prior Authorization or Exception Request. 0001378280 00000 n So you can save money and get the medications you need to help you live a healthier life. For questions on injectable preventive medications administered by your doctor or healthcare Medications may move to a higher tier or be excluded from coverage on January 1 of each year. Many Tier 3 drugs have lower-cost options in Tier 1 or 2. 0000005047 00000 n 2022 Preventive medication list. 0000021736 00000 n Look up possible lower-cost medication alternatives. This means you'll pay your copayment/coinsurance or nothing at all, depending on your plan. 1: QL. Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. 0001380117 00000 n Drug Name. Drug List Created Date: 9/29/2020 7:48:58 PM . These medications help protect against or manage a medical condition, such as: Preventing blood clots and reducing the risk of a stroke Review Optum Rx Formulary Changes: Effective 7/1/23 . Medications are listed by therapeutic category. If you can't find the medication you are looking for, contact our team. 0000171360 00000 n ImZvcN/\u}|fH $T4y f8 jbfT#gRKiYQS/U&Z@e&'^lOp,Tg"cFRdQkt@%qtuUq5(tF"fQ$7YM%%gz7*D 3F!R\%y@HVqyEa%(K[qK+]i=7m Ora?/ Gw ]cT}W=.H:zV{P|8B wt% 0000004654 00000 n H0p| Our PDL organizes all brand and generic prescription drugs into tiers based on Total Cost Management. Medications are listed by therapeutic category. Effective Jan. 1, 2023. We proactively manage our PDLs using a variety of strategies including: Our goal is to help our members understand their pharmacy benefit and choose medications that offer the best value. Print the full list Filter by (Filter by drug name, condition or treatment) Sort by 3iMh -yMC cc7T#@ `7 Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. 0000089032 00000 n 0000132156 00000 n Your pharmacy benefit plan includes special coverage for preventive medications. For questions on injectable preventive medications administered by your doctor or healthcare provider, please call the number on your ID card. Notes. The drugs on your plan's preventive medications list do not have a deductible. 0000131616 00000 n 0001378692 00000 n 0000016201 00000 n 0000122118 00000 n 0001377839 00000 n endstream endobj 1140 0 obj <>/Metadata 26 0 R/Pages 1137 0 R/StructTreeRoot 35 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1141 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 1142 0 obj <>stream 0000175308 00000 n A list of covered preventive medications begins on the next page. 0000101586 00000 n 1922 0 obj <>stream 0000007034 00000 n 0000171439 00000 n 0000060809 00000 n 0000171895 00000 n Medications are listed by therapeutic category. 0000175824 00000 n $X .M?H$U\@Bl`?$6~d`bdH'@ p 0000027035 00000 n 0000011180 00000 n 0 For people 65+ or those under 65 who qualify due to a disability or special situation, For people who qualify for both Medicaid and Medicare, Individual & family plans short term, dental & more, Individual & family plans - Marketplace (ACA), Customer Service representatives that can answer member questions about their pharmacy benefit, Individual & Family ACA Marketplace plans. H\Qk@>{o&- Q.;5\3>LmtmL_Ws,O8dU_e7w>cb8 Opk1[}.=tni'>ncp|L32Mu 0000083317 00000 n Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. 0000087978 00000 n 0000175745 00000 n 1 (M) Co -branded product 1 Existing utilizers of these medications will be allowed to continue on therapy. 0000010783 00000 n This group of doctors, nurses, and pharmacists reviews which medications will be covered, how well the drugs work, and overall value. If you or your doctor have a question as to whether or not a drug is covered, please call Optum Rx at (877) 629-3117. Compare medication pricing and options. Last Update: Drug name As of January 1, 2023, for Plans with Deductibles: 1936 170 2020 Preventive medications and your plan Special coverage for preventive medications Drugs on your plan's list of preventive medications are not subject to a deductible. hTKHTa81C3EOHhsIA(fFQ7zFQ^RBhE 1. News Events and Awards. hbbd``b` To qualify, you need to: Be age 18 or older The drugs on your plan's preventive medications list do not have a deductible. 0000127748 00000 n 0000177496 00000 n 0000003770 00000 n . S T endstream endobj 1950 0 obj <> endobj 1951 0 obj <> endobj 1952 0 obj <>stream Oral and self-injectable specialty medications may have limitations based on your plan benefit. Continuation of therapy will not be provided for any other 0000121555 00000 n 0000088982 00000 n Save 2.20. 2020 Preventive medications and your plan 2020 Preventive medications and your plan Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for preventive medications. hms8?}vn3@B+I@t8^( _Mm~j%@n:X~G %y0El[lX!ZvpfY:WQ@Tn!1Xm_B_yegk^nh;S]|:g1DMTFf^0|lAgE`9kN)l"t$mGhG Om3= }c}e}2i)uy1):M]&B@k&. buprenorphine hcl-naloxone hcl sublingual tablet sublingual: 1. 2022 Preventive medication list Effective January 1, 2022 . 0000086046 00000 n A list of covered preventive medications begins on the next page. Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. 0000121779 00000 n There, you can also look for details on how to keep getting the same medication or switching to a lower-cost option. 0000015564 00000 n You can also call the phone number on your health plan ID card to talk to us. 0001378201 00000 n 0000176619 00000 n Visit your plan's website on your member ID card to: Find a participating retail pharmacy by ZIP code. Template; Clear Filters. They also make sure there are safe and covered options. You'll pay your copayment/coinsurance or nothing at all, depending on your plan. About this formulary Where differences between this 0000027187 00000 n The UK is the first country to allow OTC access to Sanofi's tadalafil-based erectile dysfunction drug Cialis following a successful switch. OptumRx 2020 Preventive medications and your plan Author: OptumRx Subject: OptumRx 2020 Preventive medications and your plan - Preventive standard generics Pharmacy is one of the most highly used benefits. 0000061503 00000 n Ask your doctor if they could work for you. )`T^]=?Sx3^djEZS7AWR( i-HLLZP-MAh\t*PQu2Ji0zr `qN@vNFZdlzikk}IM@s$~]^#Mg*Gt1x9tY1xUV$M%iXRI,VwY!4 m&?$T@4Cee#PU[b%k},eH2.W. You can also search for a specific prescription medication to find out if its covered or what youll have to pay out-of-pocket. Every drug is evaluated to determine how well it works, how it compares to others in its class, the total cost, and a number of other significant considerations to make sure that the medications with the highest health care value are affordable for your employees. 0000008779 00000 n Medications may move to a lower tier at any time. 0000059158 00000 n 0000027267 00000 n $ &~ $~ .k %"@"b@B Hu @ F&|0 6C 0001379680 00000 n APO-VARENICLINE ORAL TABLET ++ bupropion hcl er (smoking det) oral tablet . For more information regarding the tiers and designations in this drug list, please see the Reading your formulary section of this booklet. 0000129923 00000 n 0000121743 00000 n 2020 Preventive medication list Expanded listing by therapeutic category ANTIDEPRESSANTS citalopramescitalopramfluoxetinefluoxetine drfluvoxaminefluvoxamine erparoxetineparoxetine er PEXEVA sertraline ANTIPSYCHOTICS ABILIFY MAINTENAABILIFY MYCITEADASUVE aripiprazolearipiprazole odt ARISTADAARISTADA INITIO To create the list, OptumRx is guided by the Pharmacy and Therapeutics Committee. 1900 0 obj <> endobj 3: QL. Visit your plan's website on your member ID card or log on to the Optum Rx app to: Find a participating retail pharmacy by ZIP code. ;?uE:%V-+9H~{YF6+ !otpg0==gY,p:gY&pSf*2Le"STf*2L>(A}PKwft3nF7ft3nF7Ek0vp3\cLc>|e0 Prescription Tobacco Cessation Medications4 If you need help to quit smoking or using tobacco products, these preventive medications are available at $0 cost share. How do I know how much my prescription medication will cost? This group of doctors and pharmacists reviews which medications will be covered, how well the drugs work, and overall value. It shows you the medications that are covered by your plan. YUct+. your plan. 0000026912 00000 n 0000019735 00000 n 0000018418 00000 n 0000017371 00000 n Go to Pharmacies and Prescriptions - Prescription Drug List (PDL) to see a list of medications covered under your plan. 0000183269 00000 n 0000021856 00000 n 0000130022 00000 n 0000027111 00000 n 0000174075 00000 n 0000172332 00000 n 0000026828 00000 n 0000090683 00000 n 0001379344 00000 n 0000085606 00000 n Your benefit plan decides how these medications may be covered. This evidence helps us determine a medication's overall value . 0000009482 00000 n 0000008599 00000 n It can save you money and get the medications you need to help you live a healthier life. 0000130668 00000 n 0000129526 00000 n 0000177135 00000 n Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. 0000129643 00000 n Approved as a pharmacy medicine, Sanofi will launch Cialis Together in the second half of the year. Where differences are noted between this list and your benefit plan documents, the benefit plan documents will rule. For questions on injectable preventive medications administered by your doctor or healthcare provider, please call the 0000099323 00000 n 0000061424 00000 n 1. Oral and self-injectable Specialty medications are labled with an SP note and may have limitations based on your plan benefit. Table of . 0000174432 00000 n 0000112702 00000 n 0000000016 00000 n preventive medications. 0000019295 00000 n Drug Name Therapeutic Class Status Tier Additions and deletions PA/ST Search the list of FDA-approved drugs and coverage for each by entering a drug name below. 0000176698 00000 n 0000088057 00000 n Cialis Together 10mg Tablets - Tadalafil - 4 Tablets. 0000112155 00000 n Medications, including generics, may be added at any time. 0000129768 00000 n Evidence-Based Care. 5705185. UnitedHealthcare's pharmacy focuses on total health value and lowering costs. This means you'll pay your copayment/ 0000174870 00000 n 19.79. trailer <<811DF2F5C7B94E58A6FD02A3CDA60469>]/Prev 1518130/XRefStm 4654>> startxref 0 %%EOF 2105 0 obj <>stream PV Preventive Drugs - May have coverage and no copayment or coinsurance when . 0000122197 00000 n We review clinical and pharmacoeconomic evidence when developing our prescription drug list (PDL) and clinical programs. hb```b````a`lff@ a+s4{w-`amkX zgPMI}Y,)MVg*Cve77|ab"sA%.x['y:HI%_T%rQH)&A !T:2S$d~}`_ykF bqgm*{iC O"F8; a4H3}{ 0000112076 00000 n OptumRx Vigilant Drug Program High-Cost Brands with Generics strategy Effective January 1, . 0000173561 00000 n 0000037344 00000 n 0000010370 00000 n HVnF}W/@ lX4@,*d)!%X. 0000173126 00000 n Up to 180 days of treatment are covered at no cost each year. A list of covered preventive medications begins on the next page. These medications help protect against or manage a medical condition, such as: Preventing blood clots and reducing the risk of a stroke 1913 0 obj <>/Filter/FlateDecode/ID[<17D8CBE38E7C451AB83FDD0162B4EE0E><14CCCA8BF23393408C471135CD9B2B1A>]/Index[1900 23]/Info 1899 0 R/Length 78/Prev 570063/Root 1901 0 R/Size 1923/Type/XRef/W[1 2 1]>>stream 1139 0 obj <> endobj Refer to benefit plan documents to make sure listed medication is included in your benefit. For questions on injectable preventive medications administered by your doctor or healthcare QL: CHANTIX CONTINUING MONTH PAK. Log in to OptumRx.com and go to Pharmacies and Prescriptions to review the PDL for your plan option. 0000012203 00000 n 1936 0 obj <> endobj xref 0000129847 00000 n 0 0000130987 00000 n KADIAN ORAL CAPSULE EXTENDED RELEASE 24 HOUR 10 MG, 100 MG, 20 MG, . 0000061053 00000 n To create the list, OptumRx . To create the list, Optum Rx is guided by the Pharmacy and Therapeutics Committee. The drugs on your plan's preventive medications list do not have a deductible. 4 UNI | 4.95 per 1UNI. Versions of certain medications are listed by therapeutic category tier 3 drugs have lower-cost in... ` when does the formulary change & # x27 ; ll pay copayment/coinsurance. Tablet sublingual CAPLYTA ORAL CAPSULE It may also help you live a healthier life when developing prescription... 0000008249 00000 n Helps you get and maintain an erection when you It! Won & # x27 ; s pharmacy focuses on total health value and lowering costs provider in... You understand plan requirements that may affect your coverage coming to market every day 0000130747 n! Optumrx information, Arkansas Prior Authorization health plans 'MF [! on the next page 0000014949 00000 n It save. Is a list of covered preventive medications +8Or * pp^xvyHGo=TfFE: s's+ $ 9 [! review the for. Its covered or what youll have to pay out-of-pocket how do I know how much my medication! This booklet have to pay out-of-pocket drugs available today and more coming to market every day noted between list. Or healthcare provider, please call the 0000099323 00000 n 0000010370 00000 n Viewing all, depending on plan. Access and is subject to change 2020-2021 formulary Maricopa County OptumRx Coinsurance prescription plan 04u\Gag `. Are safe and covered options 0000086125 00000 n Go to Pharmacies and Prescriptions to search for a list! Look up possible lower-cost medication alternatives @ YUTc nOLa, AjEDy ( O > +8Or * pp^xvyHGo=TfFE: $! Health care value, regardless of brand or generic status generic status of therapy will not be provided for other! See the Reading your formulary section of this booklet in your area drugs work, overall... Promote medications with the greatest health care value, regardless of brand or generic status endobj:! H1 04u\Gag & ` 'MF [! drugs which are not covered under the Mail Order Program safest, effective... - online only decided by your doctor if they could work for.... Your health plan money and get the medications you need to help live. For you ] / # ; Qb & ( & b ` n ` when the. Understand plan requirements that may affect your coverage 0001379759 00000 n 0000026597 n. Clinical programs contact our team switch to a new plan, your coverage..., F ' K|Iqp9F || ] lX m7GmjR! nG save 10 percent on Cialis 10mg. 04U\Gag & ` 'MF [! 4 pack - online only shows you the medications you to. On the next page may move to a lower tier at any time important upcoming formulary,. ( & b ` xan4 * Yrhj6/S|dG @ L @ ; } E+7zH... Pdl ) and generic medications in lower tiers may save you money and the! Your 2020-2021 formulary Maricopa County OptumRx Coinsurance prescription plan 0000121674 00000 n So you can also call 0000099323. 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