Tufts Health Plan is switching to OptumRx. See what it means for you.

A better way to get the medications you need.

November 8, 2022

On January 1, 2023, Tufts Health Plan will begin using OptumRx as our pharmacy benefit manager. CVS Pharmacy will remain in our pharmacy network so you can continue to fill your prescriptions at your local CVS. A pharmacy benefit manager (PBM) administers your pharmacy benefits. OptumRx is one of the nation’s leading PBMs and is committed to putting patients at the center of the pharmacy experience and making health care more connected. Here’s more good news: Our goal is to make this change as easy as possible for you.

Benefits to you

Here are some of the things you can expect from this change:

  • Better access – OptumRx gives you access to simple online tools, a more efficient way to get prescriptions, and guidance to make better decisions about your health. A set of innovative, easy-to-use online tools will help you manage your prescriptions, look up specific medications, review pricing options, and set up or manage your home delivery service.
  • Digital tools – A set of easy-to-use online tools will help you keep track of your prescriptions. You’ll be able to look up medications. You can also set up and manage your home delivery.
  • 24-hour support – You can get help 24/7 if you have any questions or concerns about your medications.

How to prepare

Here are a few simple ways you can get ready for January 1, 2023:

  • Look for your new Tufts Health Plan member ID card. It has details about OptumRx. Members should get new ID cards in the mail soon. Share your new card with your pharmacy for any drugs you fill on or after January 1. You can throw out your old ID card after January 1.
  • If you use specialty pharmacies, you may hear from OptumRx. You may get a call from a patient care coordinator who can help walk you through the next steps.
  • Sign up with OptumRx home delivery if you take long-term medications. Your home delivery prescriptions that have refills will move to OptumRx. Please plan to have at least a one-month supply of your current long-term medications on hand.

We’re here to help

As a reminder, CVS Pharmacy will remain in our pharmacy network so you can continue to fill your prescriptions at your local CVS. For questions or concerns about your pharmacy benefits, please call the number on the back of your member ID card. Or you can send a message to Member Services through the member portal.

We’re happy to work with OptumRx to manage your pharmacy benefits.