For the 2016-17 academic year your prescription plan and pharmacy coverage will be 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 #
Includes CVS, Safeway, Parnassus Heights (PH) Pharmacy and Walgreens.
Call: 1 (844) 265-1879
IN-NETWORK OUT-OF-NETWORK 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
$120 non-formulary brand
Not determined at this time. Prescription Benefit Year Maximum unlimited unlimited
Prescription ReimbursementStudents 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 OrderTo 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 https://www.OptumRx.com to complete the form online. Once complete you can mail in the paper version of your prescription(s) or fill out a request for Catamaran 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: 1-888-637-5121Fax: 1-888-637-5191
Out-of-California NetworkWhen 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 FormularyDownload the Approved Formulary Drug List.