Pharmacy program

Harvard Pilgrim has partnered with OptumRx for pharmacy benefit management services. The result is an easier, enhanced experience that makes it simple and convenient for clients and members to save money on prescription drug costs.

Members can get prescriptions from more than 67,000 pharmacies nationwide. OptumRx’s mail order pharmacy, OptumRx Home Delivery, gives members the convenience of having prescriptions shipped to their homes. CVS Specialty is our primary specialty pharmacy provider.

OptumRx uses technological solutions and digital tools to help keep pharmacy costs down and increase member engagement:

  • Pre-Check MyScript® helps prescribers choose the most cost-effective and appropriate medications for their patients
  • Members can manage mail order prescriptions and get updates on prior authorization status through their Harvard Pilgrim member accounts
  • Email and text alerts give members order status updates and remind them to take medications and refill prescriptions

In addition, OptumRx’s nationally recognized opioid risk management program and medication adherence program help ensure appropriate use of prescription drugs.

Look up drugs, find pharmacies, get prices and more.

Prescription drug benefit information:

Premium 3-Tier (pdf)

Premium 4-Tier (pdf)

Value 4-Tier (pdf)

Value 5-Tier (pdf)

Core NH 5-Tier (pdf)