Helpful information pertaining to your prescription drug benefits.
To find if your drug is covered, please:
To view your specific RX benefit information, login to: http://optumrx.com/catamaranrx. (Please note that by clicking on this link, you will be leaving the Memorial Hermann website).
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 OptumRx. 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 visit your OptumRX member portal website or call member services at the number listed on your ID card.
To learn more about our Drug Formulary, click here.
Memorial Hermann Specialty Pharmacy focuses on delivering high-quality, integrated care to help you achieve the best possible health by providing:
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.
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:
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.
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.
To locate a pharmacy near you, use our Pharmacy Locator Tool. (Please note that by clicking on this link, you will be leaving Memorial Hermann website).
The OptumRx® pharmacy network includes many national chain pharmacies listed in this OptumRx Pharmacy Network Listing document. Many independent pharmacies are also included in the network. Visit http://optumrx.com/catamaranrx for a comprehensive listing of network pharmacies or call member services at the phone number listed on your ID card. (Please note that by clicking on this link, you will be leaving Memorial Hermann website).
Are you taking a "long-term" medication? Enroll in home delivery. Save money and time. Learn more by reading these Home Delivery Frequently Asked Questions and download New Prescription Mail Order Forms in English and Spanish.
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:
Visit http://optumrx.com/catamaranrx 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).
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).
For more information on your pharmacy benefits, contact OptumRX Customer Service at (877) 633-4461.
For Prior Authorizations, download a Texas Prior Authorization Form. For more information, contact OptumRx by phone at (877) 633-4461. Physicians can contact 1 (800) 711-4555 or fax information to (844) 403-1029. Physicians can also go online at CoverMyMeds.com or OptumRx.com.
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 1 (800) 711-4555 or fax information to (844) 403-1029. Physicians can also go online at CoverMyMeds.com or OptumRx.com.