End of the Federal Public Health Emergency for COVID-19
Recently, the Department of Health and Human Services (HHS) announced the end of the federal Public Health Emergency for COVID-19, effective May 11, 2023. As a member enrolled in a Health Options Program Medicare Rx Option, we want to help you understand what this means for your benefits coverage and answer any questions you may have.
What this means starting May 12, 2023
Between now and May 12, 2023, there is no change to how COVID-19-related services are covered.
OptumRx, the administrator for the Health Options Program Medicare Prescription Drug Options, will be ending certain operating flexibilities that were put in place during the Public Health Emergency. Your prescription drug benefit will resume all normal operating policies and coverages as outlined in the Evidence of Coverage (EOC) and the Utilization Management (UM) criteria for formulary medications. This includes, but is not limited to the resuming of:
- Quantity limits on some medications
- Refill too soon edits as per normal operating policy
- Transition fills to the normal 30-day supply
You can find a copy of the 2023 Evidence of Coverage on the Medicare-Eligible Resources page. If you have questions regarding your prescription benefits, contact OptumRx at 1-888-239-1301 (TTY/TDD: 1-800-498-5428) 24 hours a day, 7 days a week.