Pharmacy Benefit Information

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Questions? Contact Customer Service at (855) 645-8448

Pharmacy Benefit Information 

To find if your drug is covered, please click our Drug Lookup Tool below:

Formulary Search 2020
Formulary Search 2021

(Please note that by clicking on the links above, you will be leaving the Memorial Hermann website).

Drug Formulary

Download our Comprehensive Drug Formulary* below:

* Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change pursuant to the formulary management activities of the Prescription Benefit Manager. The presence of a medication on this formulary list does not guarantee coverage. To determine the most up-to-date formulary status of your medication, please call member services at the number listed on your ID card.

To learn more about our Drug Formulary, click here.

Pharmacy Network

To locate a pharmacy near you, use our Pharmacy Locator Tool in the links below:

Pharmacy Search 2020
Pharmacy Search 2021

(Please note that by clicking on the links above, you will be leaving the Memorial Hermann website).

Memorial Hermann Specialty Pharmacy

Memorial Hermann Specialty Pharmacy focuses on delivering high-quality, integrated care to help you achieve the best possible health by providing:

  • Timely and reliable delivery of your specialty medication from the locally based pharmacy in Katy.
  • Free delivery, regular refill reminders and important updates.
  • Knowledgeable, helpful staff to assist you with your specialty medication.
  • A pharmacy with a direct connection to Memorial Hermann providers, hospitals and clinics.

Learn more by visiting and by reading their Frequently Asked Questions.

Specialty Drug List

The Memorial Hermann Specialty Pharmacy Medication List is a listing by therapy of specialty medications that Memorial Hermann Specialty Pharmacy can provide or facilitate access, and is subject to change. For more information about specialty medications, please visit Memorial Hermann Specialty Pharmacy.

Rx Preventive Services

In addition to a healthy lifestyle, preventive medications can help people avoid many illnesses and conditions. Preventive medications are defined as those prescribed to prevent the occurrence of a chronic disease or condition for those individuals with risk factors, or to prevent the recurrence of a disease or condition. Some examples of the medications listed are for high blood pressure, high cholesterol, diabetes, asthma, osteoporosis, and heart disease. This list provides examples of your preventive medications by drug category/therapeutic classification. Medications may be added to or removed from the list, depending on different factors, including the intended purpose of the medication and new medications.

Download our Preventive Drug List below:

Health Care Reform Preventive Care

Under the health reform law (Affordable Care Act), benefit plans must cover certain Preventive Care Medications at 100% - without charging a copay, coinsurance or deductible. This is a list of prescription and OTC drugs with a valid prescription that is required to be covered by ACA regulations at $0 copay at any network pharmacy.

Transition Program

If you experience a disruption to one of your current medications during the first 60 days of enrollment, we can provide a temporary one month supply while you consult with your physician. If it is decided that a formulary alternative is not best for your situation and should remain on the drug, you can then ask the plan for a formulary exception.

Home Delivery Information and Forms

Are you taking a "long-term" medication? Enroll in home delivery. Save money and time, download new Prescription Mail Order Forms.

2020 Mail Order Form – English
2020 Mail Order Form – Spanish
2021 Mail Order Form – English (Coming Soon)
2021 Mail Order Form – Spanish (Coming Soon)

(Please note that by clicking on the links above, you will be leaving the Memorial Hermann website).

OptumRx Member Portal

This private, secure website is designed just for you. All of your pharmacy plan information is available and kept up-to-date in real time.

Easy access allows you to:

  • Manage all your prescriptions on a single dashboard
  • Update your information and complete health profile
  • for home delivery
  • Order mail order refills
  • Compare prices at local pharmacies
  • Find your lowest prescription cost
  • Locate your pharmacy and get driving directions
  • Keep track of your health history
  • Learn more about your drugs
  • Take it all with you through the mobile app
  • Manage prescriptions for your dependents and family members, where appropriate
  • And much more.

Visit and use your member ID number to register. Questions? Call OptumRX Customer Service at (877) 633-4461. (Please note that by clicking on this link, you will be leaving Memorial Hermann website).

OptumRx Mobile App

The mobile app provides easy, on-the-go access to your personalized health information. Once you have your member ID number, download the app to take advantage of the benefits your pharmacy plan offers. Managing your prescription medications is a key part of managing your health. Take your medication information with you wherever you are with the mobile app. Download now for iOS and Android devices. (Please note that by clicking on this link, you will be leaving Memorial Hermann website).

Contact Us

For more information on your pharmacy benefits, contact OptumRX Customer Service at (877) 633-4461.

Additional Documents and Forms

Member Reimbursement Drug Claim Form - English
Member Reimbursement Drug Claim Form - Spanish

For Prior Authorizations, download a Texas Prior Authorization Form. For more information, contact OptumRx by phone at (877) 633-4461. Physicians can contact (800) 711-4555 or fax information to (844) 403-1029.  Physicians can also go online at or

If you disagree with a Prior Authorization decision, you have the option to appeal the decision within 180 calendar days. For Appeals, download the OptumRx Appeal Request Form. For more information, contact OptumRx by phone at (877) 633-4461. Physicians can contact (800) 711-4555 or fax information to (844) 403-1029.  Physicians can also go online at or

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