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
2024 Pharmacy Formulary: PDF | Searchable List
How much do prescription drugs cost?
To see pharmacy costs, including mail-order costs, choose your 2024 plan from the list below:
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.