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Video instructions and help with filling out and completing Emgality Prior Authorization Request Form OptumRx
Instructions and help about Emgality Prior Authorization Request Form OptumRx
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People also ask
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Is Saxenda covered by OptumRx?
Optum Rx standard formularies currently include the weight loss drugs Wegovy and Saxenda, and the PBM is evaluating Zepbound. Beginning Jan. 1, 2024, Optum Rx will begin offering plan sponsors a new weight management and wellness support program. -
What are the requirements for OptumRx Wegovy?
Wegovy is also approved for chronic weight management in adults with an initial BMI of 30 kg/m2 or greater (obesity) or a BMI 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia). -
What is the fax number for OptumRx specialty prior authorization?
Please have the doctor or a qualified member of the office staff complete the next page(s) and fax the completed form to 1-844-403-1024. If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555. -
How do I send my prescription to OptumRx?
(OptumRx Mail Service) 6800 W 115th St, Suite 600 Overland Park, KS 66211-9838 NCPDP: 1718634 Call 1-800-791-7658 – Provide a verbal prescription directly to an Optum Rx provider dedicated pharmacist. Fax 1-800-491-7997 – Send a complete prescription using the Physician Fax Form. -
How do I submit PA to OptumRx?
Submitting a PA request to OptumRx via phone or fax above. For urgent requests, please call us at 1-800-711-4555. (Hours: 5am PST to 10pm PST, Monday through Friday.) -
What is the difference between Saxenda and Wegovy?
Wegovy is injected less often than Saxenda Wegovy lasts longer in the body compared to Saxenda. Because of this, you don't have to inject it as often. Wegovy is injected once a week, while Saxenda is injected daily. You should inject your Wegovy dose on the same day each week, at any time of day. -
Is Saxenda a Tier 1 drug?
Saxenda is covered on the OptumRx Select and Premium Formularies at Tier 3 with Prior Authorization. -
How much are Tier 3 drugs on OptumRx?
Non-preferred brand drugs (Optum Tier 3) 30-Day Supply Retail Pharmacy: $50 Copayment 90-Day Supply Retail Pharmacy : $150 Copayment 90-Day Supply Mail Order Pharmacy: $150 Copayment Some generic drugs are in this tier.
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