Prescription Plan

Optum Rx Logo

Pharmacy benefits are managed by Optum Rx on behalf of the UC Student Health Insurance Plan (UC SHIP). There is no annual pharmacy benefit limit. Enrollees may purchase prescribed medications from any pharmacy, but will receive the greatest benefit from an in-network pharmacy.

On the UC SHIP website, you can find details and important information about your plan as well as contact information and network providers.

  • Prescription & Pharmacy

    Billing Optum Rx
    PO Box 968022
    Schaumburg, IL 60196-8022
    1 (844) 265-1879
    Member ID Call: 1 (866) 940-8306

    Rx Group #

    BIN Number




    Optum Rx
    Includes CVS, Safeway, Parnassus Heights (PH) Pharmacy and Walgreens.
    Call: 1 (844) 265-1879
  • Benefit Summary

    Generic $5 co-pay $5, then 60% of billed charges
    Brand $25 co-pay $25, then 60% of billed charges
    Non-formulary Brand $40 co-pay $40, then 60% of billed charges
    Mail Order (90 day supply) $15 generic
    $75 brand
    $120 non-formulary brand
    Not determined at this time.
    Prescription Benefit Year Maximum unlimited unlimited
  • Prescription Reimbursement

    Students can get partial reimbursement for medication obtained outside of network pharmacies.  Students must mail a Prescription Claim Form to the claims administrator within 90 days of the date of purchase. If it is not reasonably possible to submit within that time frame, an extension of up to 12 months will be allowed. Prescription claim forms and customer service are available by calling 1 (844) 265-1879.
  • Mail Order

    To receive your prescriptions via Mail Order with free standard shipping, please complete the OptumRx Home Delivery Form and mail or fax with your maintenance presciption written for a 90-day supply. You also have the option to log onto to complete the form online. Once complete you can mail in the paper version of your prescription(s) or fill out a request for Optum Rx to fax your provider.
    Information on the member's other medications (prescription and over the counter), allergies, health conditions, and method of payment are required prior to filling a script.

    OptumRx Home Delivery
    PO Box 2975
    Mission, KS 66201
    Tel: 1-888-637-5121
    Fax: 1-888-637-5191
  • Out-of-California Network

    When out-of-California, students can locate a participating  pharmacy by calling 1-844-265-1879. If students cannot locate a participating pharmacy, they can pay for the drug and submit a  Prescription Claim Form to the claims administrators.
  • UC SHIP Formulary