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Prescription Coverage

Picking Up Prescriptions

Make sure to bring your OptumRX ID card when you pick up your prescriptions.

When using a participating pharmacy, SHP members generally have a $12 copay for generic drugs, and a $40 to $60 copay for brand and specialty drugs.

Log in to your account through or the OptumRx app to learn more about your prescription coverage, drug pricing, and to find participating pharmacies.

Prescriptions Requiring Prior Authorization

  • To find out if your prescription requires prior authotization, look up the name of your prescription drug in the OptumRX Formulary below.
  • If there is a PA (prior authorization), QL (quantity limit), or ST (step therapy) in the Notes column, consult with your prescribing provider about how that might affect your pharmacy prescription.
  • If there is an E (excluded) in the Notes column, that means the drug is not covered by OptumRX. Refer to the OptumRX Premium Formulary Exclusions document below for preferred alternatives for excluded medications, and consult with your prescribing provider about changing your pharmacy prescription. (For an accommodation for this PDF, please contact

OptumRX Formulary (Effective 1/1/24)

OptumRX Premium Formulary Exclusions (Effective 1/1/24)

OptumRX Preventive Care Medications (Effective 1/1/24)

Pharmacy Benefits for COVID-19 (Effective 5/12/23)

Copay Waiver Request Form (Including for Contraception)

Questions about your prescription coverage? Log in to or call OptumRx customer service at 1-866-868-1677.