Your pharmacy benefits are provided under the County's self-insured pharmacy plan through Catamaran/OptumRx. Some of the plan features include: a large network of participating pharmacies and a 90-day mandatory maintenance medication program (excludes specialty).
Non-Preventive Prescription Drugs
- The discounted drug cost is applied to the deductible.
- After the annual health deductible is met, the plan pays 80% and the member pays 20% coinsurance of the discounted drug cost.100% Coverage after the annual health out-of-pocket is met; prescription drugs are paid in full by the plan.
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.
To verify in advance, members may contact Catamaran/OptumRx.
Frequently Asked Questions - Prior Authorization Program
Member Services: 1-855-356-3216