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Pharmacy Program

As of Jan. 1, 2020, Harvard Pilgrim began utilizing OptumRx as our pharmacy benefit manager; providers must obtain pharmacy prior authorizations through OptumRx and submit mail service prescriptions to OptumRx Home Delivery. Harvard Pilgrim manages our own drug formularies, the development of utilization management criteria, and appeals. Harvard Pilgrim uses CVS Specialty as our specialty pharmacy vendor, and Village Fertility Pharmacy and Freedom Fertility Pharmacy as our fertility pharmacy vendors.

Useful Resources for Opioid Prescribing

Preventive Drug Lists

Premium Formulary Preventive Drug list

Value Formulary Preventive Drug list

NH Core Formulary Preventive Drug list

Ways to order medications

Find a Pharmacy

Retail 90

Mail Service Prescription Drug Program

Specialty Pharmacy Program

Infertility Pharmacy Program

Medications with limitations and restrictions

Compound Drug Coverage

Exception Requests (Premium and Value Formulary)

Information about medications

Find drug information
Information on thousands of prescription and over-the-counter medications from MedlinePlus

Find unbiased drug reports and recommendations
from Consumer Reports Best Buy Drugs

Committees and other programs

Pharmacy & Therapeutics Committee