Welcome to Optum Rx

Change happens. We’re here to help you have a smooth transition and access to your medication.

My account

Medication pricing and coverage

See how your costs and coverage may change.

Talk to an advocate

Get help or ask questions.

Video library

Who is Optum Rx?

November 10th, 2023

Visit our video library to learn more about your plan.

What is prior authorization?
Understand prior authorizations and what you may need to do before filling a prescription.
Optum Rx online tools
Discover how our online tools can help you manage your prescriptions.
What is a formulary?
Learn how to use your plan’s formulary, or prescription drug list, to make decisions about your medication.

General Information

Recent Changes to TennCare

Frequently Asked Questions

Prior Authorization Forms

Clinical Criteria and CoverKids Formulary

CoverRx/CoverKids MAC List

Prescriber

As the main caregiver of our member’s health, OptumRx is excited to partner with you on educating and providing care for our members. Here you will find important Program Information, Prior Authorization Forms, Clinical Criteria and all Prescriber Communications needed to provide an overall continuity of care.

Important Update: Due to recent shortages of albuterol HFA products, the following products will be changed to preferred status on the CoverKids formulary: ProAir HFA, ProAir Respiclick, and Ventolin HFA.

Clinical Criteria and CoverKids Formulary

Prescriber Communications

Prior Authorization/Appeals forms

Related Links:

TennCare

CoverRx

Enrollee

As a member of CoverKids, OptumRx is here to help with your pharmacy needs. Here you can find participating pharmacy, order a replacement ID card and much more.

We obey federal and state civil rights laws. We do not treat people in a different way because of their race, color, national origin, language, age, disability, religion, or sex. Do you think we did not help you or you were treated differently because of your race, color, national origin, language, age, disability, religion, or sex? To report different treatment to TennCare find more information at: https://www.tn.gov/tenncare/members-applicants/civil-rights-compliance… or email: HCFA.fairtreatment@tn.gov.

Related Links:

A message from Adam Anderson: CEO of Testclient

Hello Testclient employees and Family members. We know transitioning prescription drug benefits can be a tricky and tedious process. Our team at Testclient has spent many hours researching, comparing, and and negotiating to offer you the best prescriptions drug coverage we could find. Our goal is to offer you reliability, flexibility, and cost savings through the benefit package we offer. We have selected OptumRx because of the extensive pharmacy networks offered, their industry leading digital tools, and their proven success record in onboarding new members. We are excited for this new chapter in our benefits offering with OptumRx.

Grocery Benefit

At any age, it is important to eat a diet of healthy, nutritious foods to protect against many chronic condition and diseases. Eating healthy can help you live longer, support your muscles and bones, boost your immunity, and make it easier to perform day-to-day activities. As part of your Testclient benefit package, you are eligible for "grocery benefits". Fruits and vegetables (fresh, canned, or frozen), dairy products, meat, seafood, beans and legumes, and healthy grains are some of the eligible purchases under the benefit. Visit our benefits page for more information.

Testclient benefits page

Specialty Medications

If you take medications for conditions such as hepatitis C, multiple sclerosis or rheumatoid arthritis, your provider must order your prescriptions through our designated specialty pharmacy, OptumRx Specialty. Delivery will be made to your home or office, provider's office. OptumRx Specialty offers emergency overnight or same-day delivery via mail or courier, around-the-clock telephone access to nurses and clinical pharmacists, and educational materials.

OptumRx Specialty Pharmacy

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