Student Health Insurance Plan Pharmacy Benefit
Use UnitedHealthcare (OptumRx) participating pharmacies and present your insurance ID card. The Campus Health Pharmacy is a participating pharmacy under the plan.
- UnitedHealthcare online provider directory: www.uhcsr.com/arizona
- Preferred Care Policy Year Out-of-Pocket Maximum: Combined Medical & Pharmacy $1,500 (includes copayments, deductible, and coinsurance)
- Policy Year Pharmacy Deductible: $125 (waived at the UA Campus Health Pharmacy)
- Additional UnitedHealthcare Pharmacy Plan information can be found at www.uhcsr.com/arizona under Helpful Links.
Prescription Copay Schedule
- Tier 1: $15 copay
- Tier 2: $40 copay
- Tier 3: $80 copay
Contraceptives
Generic contraceptives are covered at 100%.
Note: Brand-name contraceptive prescription drugs or devices from a preferred provider will be covered at 100% of the negotiated charge, including waiver of per policy year pharmacy deductible if a generic contraceptive prescription drug or device is not available in the same therapeutic drug class or the prescriber specifies dispense as written.
Transition of Care
Transition of Care for medications/prescriptions that require Prior Authorization, Step Therapy, or Specialty Pharmacy: Please call Optum Transition of Care team at 1-800-356-3477 or sign into your UHCSR "My Account".