Arizona Community Plan: Pharmacy policy updates effective Dec. 1

Effective Dec. 1, 2023, we’re moving UnitedHealthcare Community Plan’s coverage for 2 medications and a therapy class from Optum Infusion to Optum Specialty for Arizona Complete Care (ACC), Developmentally Disabled (DD) and Dual Special Needs Plan (DSNP).

The impacted medications and therapy class include:

• Humira
• Enbrel
• Growth Hormone

How these changes affect you

These medications and therapy class are currently handled by the member’s medical benefit, Optum Infusion. However, as of Dec. 1, they’ll be fulfilled by Optum Specialty, the member’s pharmacy benefit. This means Optum Specialty will manage prior authorization requests for these medications and therapy class.

• Existing prior authorizations: Health plan staff from Optum infusion will transfer any existing prior authorizations to Optum Specialty
• Renewals and new prior authorization requests: Prescribers will need to submit all renewing and new prior authorizations to Optum Specialty

Optum Infusion and Optum Specialty will jointly coordinate member transition efforts to help ensure affected members experience a smooth, undisrupted mediation distribution.

Resources

You can find the updated vendor list, prior authorization guidelines and additional information on our Pharmacy Resources and Physician Administered Drugs web page.

Questions?

Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal. You can also contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.

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