OptumRx COVID-19 FAQs

March 9, 2020

As of March 6, 2020

The CDC is the primary source for the latest updates on COVID-19. For the most current information, please go to their site: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Does OptumRx anticipate any type of delays to dispense prescription medications?

We do not anticipate delays in dispensing prescriptions from Optum-owned pharmacies (Optum Home Delivery, Optum Specialty, Optum Infusion Services, Avella, Genoa, Diplomat) related to COVID-19. OptumRx is prepared to use anticipatory analysis to determine if, and when, we need to expand operations to include advance dispensing, workforce management, medication access, and more involved in ensuring we secure the medications needed for our patients and ability to deliver those medications to members.

How will OptumRx ensure adequate drug supplies and contingency staffing associated with your home delivery and other supply chains?

We’ve successfully managed challenging situations in the past including H1N1, Epi Pen shortage, and numerous natural disasters. We are monitoring the supply chain and actively working to maintain a reliable inventory. We’re also evaluating drug supplies going out to our pharmacies and ensuring our best practices and disaster recovery plans are implemented to meet the operational requirements of the organization.

Will OptumRx take steps to help members and prescribers adjust to supply chain disruption and find therapeutically equivalent medications in case supply challenges do occur?

Yes, similar to when we have an out-of-stock or recall situation today, we partner with our members and prescribers to identify alternatives and streamline the process to drive a faster turnaround and ensure our members have the therapy they need when they need it.

Will medications used to treat COVID-19 be covered in my plan?

Medications used in supportive care for the treatment of COVID-19 will be covered per the member’s current health plan benefit design. While there is no current treatment other than supportive care, OptumRx is monitoring the use of anti-viral products and production of a vaccine and will continue to aggressively monitor CDC recommendations and outcomes of clinical studies.

Is OptumRx proactively waiving any refill-too-soon edits?

Our first priority is to ensure our members have access to the diagnostic and treatment care they need, and we are continuing to work with our customers and policymakers on this public health challenge. OptumRx is following all guidance issued by the CDC, state and local public health departments in supporting our customers’ needs. OptumRx is actively engaged in monitoring state and federal notices regarding any state of emergency or other dictated actions in response to COVID-19.

What if a member is willing to pay out of pocket to stockpile medications?

Consistent with AMCP and other published policy, stockpiling is not encouraged because shortages are likely to increase when stockpiling occurs. We continue to assess if policy should change as CDC guidance evolves.

If lab test confirmation is required as part of utilization management criteria of a specialty drug, how will OptumRx ensure access to the specialty drug in the case of a quarantine?

OptumRx will evaluate the need to relax required utilization management criteria including any required lab tests for those members impacted by a quarantine.

How will OptumRx support access to a COVID-19 vaccine?

There is currently no approved vaccine for this virus. As soon as one is available, we will work to ensure access for our customers. We have a network of 68,000 pharmacies that can dispense vaccines and we will actively work with our pharmacies to administer any vaccines based on CDC recommendations and national availability.

Can the OptumRx customer service or website help identify local pharmacies in a member’s geography which offer delivery service?

We recommend members contact their local pharmacy directly to check if they offer delivery service or determine if their prescription can be filled by OptumRx’s home delivery service.

How can I find out if my local pharmacy is open to pick up a prescription?

We recommend you contact your local pharmacy directly to determine if they are open and filling prescriptions.

What role will OptumRx Home Delivery play in the distribution of acute prescriptions in the case of quarantine?

OptumRx Home Delivery will continue to play its primary role in the supply of chronic maintenance medications and a limited number of acute medications. OptumRx will continue to work collaboratively with our network of 68,000 pharmacies who are best situated to dispense acute medications.

Are your medications safe, or could they be carrying COVID-19?

At this time, OptumRx has no reason to suspect any concerns with medications being used in our pharmacies and is continuing to monitor the drug supply chain. OptumRx is firmly committed to the highest standards in selecting the vendors from which we source medications. Our prescription medications are purchased from approved sources that are safe and effective, and that have implemented protections that comply with all FDA regulations as well as national standards of the Verified Accredited Wholesaler Drug program (VAWD).

Will OptumRx allow members to change their retail prescriptions to Home Delivery?

If a member is interested in switching a prescription to Home Delivery, they can check through the OptumRx.com website to see if it is available. If a consumer is already on the phone, we will work with them through our normal onboarding process for new Home Delivery customers.

Get Help

Contact the HOP Administration Unit for assistance with your questions.