All of the County’s health plans are Open Access which means members do not select a Primary Care Physician (PCP) and NO referral is needed in order to see most network specialists. Members are encouraged (but not required) to see a primary care or family medicine physician for routine care. Physicians listed under the Primary Care and Family Medicine category on MyUhc.com have a lower copay/cost than physicians listed as a Specialist. Because it is not required that you obtain a referral to see a specialist, it is recommended you keep your primary/family physician up to date on any specialty care received so that all your personal health care information resides in one location.
EXCLUSIONS AND LIMITATIONS
All health plans have specific Exclusions and Limitations. Please contact the on-site UnitedHealthcare Reps for more information.
Pharmacy Benefits - CDH 2018
Your pharmacy benefits are provided under the County's self-insured pharmacy plan through OptumRx. Some of the plan features include:
- an open formulary with five tiers of coverage at affordable copays,
- a large network of participating pharmacies,
- a 90-day mandatory maintenance medication program (excludes specialty).
Consumer-Driven Health (CDH) Plans - 2018 Copay Rates
30 Day Supply Only
|Dispense-as-Written (DAW1) & Excluded Drug ("Tried & Failed")
*Pharmacy can only fill a 30-day supply for maintenance medication 3 times before requiring a 90-day refill.
Clinical Prior Authorization Program
Certain prescriptions require “clinical prior authorization,” or approval from your plan, before they will be covered. The categories/medications that require clinical prior authorization may include, but are not limited to: Acne (topical-after age 24), ADHD/Narcolepsy (after age 19), Botulinum Toxins, Lamisil/Sporanox, Obesity and Peniac. Upon receipt of a prescription falling into a covered category, Catamaran will contact your doctor’s office and request the documentation needed for Prior Authorization.
On-Site Reps: 954-357-7191 & 7192
Member Services: 1-855-356-3216
BriovaRx is Optum’s specialty pharmacy provider. They will assist members with their specialty medications to ensure safe and effective administration. BriovaRx provides free home delivery to your home/work address. Please contact BriovaRx for more information regarding specialty pharmacy.
Member Services: 855-427-4682