Pharmacy costs

As a Tufts Health Direct member, you can get covered drugs with a doctor’s prescription. You can also get many prescription drugs by mail. You can get up to a 90-day supply of your prescription drugs, often for less money. Shipping is free, and refilling your prescriptions is easy. Most drugs listed in our formulary are covered by mail-order:

• 2023 Pharmacy Formulary: PDF | Searchable List
• 2022 Pharmacy Formulary: PDF | Searchable List

How much do prescription drugs cost?

To see pharmacy costs, including mail-order costs, choose your 2023 plan from the list below:

How do I get prescription drugs by mail?

To get your prescription drugs by mail, follow the instructions on the OptumRx order form. You can order refills:

• Online with an OptumRx account
• By phone at 800-356-3477
• By mail using an order form

Additional information

• When generic drugs are available, we may not cover the brand-name drug unless we have given you prior approval. If we approve the brand-name drug, you will pay a Tier 3 copayment or coinsurance, depending on your plan level.
• We will not cover drugs that are not on our formulary unless we have given you prior approval. If we approve a drug not listed on the formulary, you will pay a Tier 3 copayment or coinsurance.
• Requests for reimbursement for drugs must be submitted within one year from the date of service.
• We cover prescription family-planning drugs and supplies with no copayment or coinsurance.
• We cover diabetes testing supplies with a prescription.
• Learn more about cost sharing.