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Which Insurance Uses OptumRx?

Published in Pharmacy Benefits 1 min read

OptumRx serves as the Pharmacy Benefit Manager (PBM) for a significant portion of health plans offered through CalPERS, including specific Anthem Blue Cross plans.

OptumRx plays a crucial role in managing prescription drug benefits for many individuals. As a Pharmacy Benefit Manager, OptumRx handles various aspects of prescription drug coverage, such as processing claims, negotiating drug prices, and maintaining pharmacy networks to ensure members have access to necessary medications.

For members of the California Public Employees’ Retirement System (CalPERS), OptumRx is the designated PBM for most of their health plan offerings. This partnership ensures that eligible members enrolled in these plans have access to OptumRx's comprehensive network of pharmacies and benefit management services for their prescription needs.

The specific CalPERS health plans that feature OptumRx for their pharmacy benefits include:

Insurance Plan Name Plan Type Region/Notes
Anthem Blue Cross Traditional Health Maintenance Organization (HMO) CalPERS Health Plan
Anthem Blue Cross Select Health Maintenance Organization (HMO) CalPERS Health Plan
Anthem Blue Cross EPO Exclusive Provider Organization (EPO) Del Norte Region

This integration highlights OptumRx's role in streamlining prescription services and managing costs for a wide array of beneficiaries under these specific health plans.