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Optum Home Delivery
also known as OptumRx Mail Service

Getting started

To begin filling prescriptions through OptumRx, head to optumrx.com and create an account (or sign into the one you already have), then follow the steps listed below.

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OptumRx also owns a specialty pharmacy by the same name that only fills "specialty" medications (for more info about how specialty pharmacies differ from traditional mail order pharmacies, click here). My (admittedly limited) experience working with Optum Specialty Pharmacy has proven it be a similar online experience to their traditional mail order pharmacy, but they do appear to partake in more care coordination and direct communication with patients (e.g., even though I technically help manage one of my patient's specialty medications through Optum, I commonly find that they've already communicated with my patient directly or helped them place an order over the phone when I reach out to them about ordering a refill—thus, it's a process I'm still trying to iron out). To visit Optum Specialty Pharmacy's website, click here.

01

​Click on Register and enter your personal and health plan information or Sign in with HealthSafe ID if you already have a HealthSafe ID account (the term Optum uses to refer to their members' online accounts).​

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  • Sometimes, patients unknowingly have a HealthSafe ID account that was made for them automatically when they signed up with their insurance plan. If your personal details help locate an account that you don't recognize or can't login to (e.g., if the email address associated with the account is no longer accessible to you), call OptumRx directly at (800) 356-3477 to get assistance with logging in.

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02

Once logged in, click on My profile in the light gray navigation bar to update the settings listed below.

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Payment methods: Here you’ll enter details for the card(s) you’d like to use to pay for your medication(s). As with any online ordering system, I recommend using a credit card in case there is ever a fraudulent transaction (versus a debit card, which doesn’t offer the same fraud protections).

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Shipping addresses: Here you’ll enter the address(es) where you’d like your prescriptions to be shipped.

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Copay savings cards: Here you can add a copay savings card (e.g., a manufacturer coupon or grant funding) to your account. You'll need the name of the medication it applies to and the RxBIN, RxPCN (if applicable), and RxGRP (if applicable). This is a newer setting that I admittedly don't yet have experience using (I've always either called Optum directly or sent a secure message through my patient's account to provide this information), but I'd give it a try and see if it works for you.

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Contact information: Confirm that your email, phone number(s), and addresses(s) are correct.

 

  • If you need to change the email address on your profile, make sure to sign out of your account before clicking on the verification link that will be sent to your email. Otherwise, if you’re still signed into your OptumRx account in a different browser tab when you click on the verification link, it will give you an error message. ​

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Communication preferences: Here you can select what kinds of notifications you’d like to receive and how you’d like to receive them (text, email, and/or phone).

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  • Under Paperless Settings for Required Communications, select whether you’d like to receive required communications by mail or “paperless” via email. 

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  • Under Notifications and Reminders, make sure to enroll in text notifications for “Pharmacy care information” and “Pharmacy order notifications” (and any others you’d like). See below for more info on why I recommend turning on text notifications, at least until you're able to confirm whether you'll receive email notifications from them or not.

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  • Under Personalized Emails, select whether you’d like to receive "personalized emails" from OptumRx (these are NOT emails about your prescription orders or pharmacy care). I always select "no" for my patients, as the vast majority of communications from insurance companies/PBMs/mail order pharmacies are for marketing purposes.

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Based on my experience thus far, OptumRx sends the following types of notifications via email, if you have email notifications turned on (as someone who doesn't have experience using them, I can't speak to the nature of their text notifications). However, please be aware that only some of my patients receive some/all of the email notifications noted below, and I have yet to determine why this is the case for some and not others. I'd suspected it might have to do with whether a patient is signed up for paperless delivery (versus mailing) of required communications, but that doesn't seem to be the case. Given I find the utility of their emailed notifications to be far greater than that of their text notifications, this is an issue I'm actively investigating and I will update this section of the cheat sheet when I know more. If you discover that you're not getting these notifications via email and find a way to change that, please let me know here!

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New prescription ready for refill | NO (rather, you'll receive a notification that an order is already processing for you)

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Refill reminders | YES

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Prescription out of refills or expiring soon | YES

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Order placed | YES

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Refill too soon | YES

Pharmacy hasn't heard back from your provider (e.g., about a new prescription or information they need before filling your prescription) | YES

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Order processing | YES

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Order shipped | YES

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Shipment out for delivery | NO

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​Shipment delivered | YES

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Secure message (that you sent them) received | YES

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Response to secure message available | YES

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Prior Authorization (PA) decisions | YES

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Payment method expiring soon | UNSURE

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Caregiver management: Here you can input the name, date of birth, and contact information for a person in your life who you’re ok with contacting OptumRx on your behalf. This person will then be sent an invite via email to register for an OptumRx account (if they don’t already have one) where they will enter the special access code included in the email invitation to complete the caregiver registration process.​​

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  • Unfortunately, I've experienced an issue with this setting not "taking" or "sticking" with multiple patients. In these cases, I've confirmed that both my patient's and my own OptumRx account show that I've been successfully set as their caregiver, but OptumRx operators don’t see that reflected in their system when I give them a call on the patient's behalf (also, unfortunately, after hundreds of phone calls with them I have yet to figure out why this happens or how to prevent it). If this happens to you, call OptumRx directly with your preferred caregiver on the line (when you're together in person or via conference call) to provide verbal consent to add that person as an authorized representative on your account—after taking this step, I've never encountered the same issue.

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  • Note that you can also add “care recipients” to your account, if there are other people in your household who use OptumRx mail order pharmacy and for whom you’d like access to manage their mail order needs (e.g., a child with the same insurance plan as you).

 

Manage HealthSafe ID sign in and security settings: Here you can change your username, password, and security settings (how OptumRx will contact you to verify your identity if you get locked out of your account).

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  • Note that, to enter this setting, you must complete a two-step verification by receiving a code via phone or text.​

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03

Now that your mail order account is set up, contact your healthcare provider(s) to request that they send a new prescription order directly to the OptumRx mail order pharmacy. 

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If you take multiple medications that are prescribed by more than one provider, you’ll need to reach out to each of them separately. If they ask why your prescription(s) can’t be transferred from your current pharmacy, inform them that traditional mail order services aren't willing to contact other pharmacies for prescription transfers (many clinics are not aware of this). If they ask, you can provide them with the following prescribing information:

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  • ePrescribe: Optum Home Delivery (OptumRx Mail Service)​

  • Phone number for calling in prescriptions: (800) 791-7658

  • Fax number for faxing in prescriptions: (800) 491-7997

  • Address: 6800 W 115th St, Suite 600, Overland Park, KS 66211-9838

  • ​NCPDP ID: 1718634

    • Many clinics aren't aware of what this number is (a type of provider ID specific to pharmacies), yet most mail order services list it in their contact information. If the clinic doesn't ask for it, I don't offer it, unless they're having trouble locating the pharmacy in their ePrescribe software.

 

I recommend that you request they send a 90-day / 3-month supply prescription, unless there is a reason that you’d like a lower quantity filled each time you order. Filling 3 months’ worth is appropriate for many medications and usually more convenient (of note, many independent pharmacies will only fill monthly supplies of expensive brand name medications because they lose even more money when filling larger quantities of these kinds of drugs). Additionally, it's often the most cost-effective option when filling with a mail order pharmacy (sometimes, they will even offer patients a free copay, giving you 3 months of medication for the price of 2 months’ worth).

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  • Certain medications used on a weekly basis, such as injectables like Ozempic and Praluent, are often prescribed in a days’ supply that is divisible by 7 (e.g., an 84-day supply instead of a 90-day supply for 3 months of medication).

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  • If your provider sends a prescription for the wrong days' supply (e.g., 30 days instead of 90 days), you'll likely need to have them re-send a corrected prescription. Unfortunately, traditional mail order pharmacies aren't usually willing to adjust the days' supply from how the prescription is written, even if it's possible and medically appropriate. 

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04

Once your provider sends a new prescription and that prescription has been received by OptumRx, the mail order pharmacy will begin processing your refill (or first fill, if this is a new medication for you) immediately without asking for your consent. For this reason, it's best to be on the lookout for notifications from them or login to your account daily so that you can ensure they end up processing an order for the correct medication, dose, and days' supply (and provide consent for them to begin filling the prescription, if needed).

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  • New prescriptions might not display information like the prescriber, number of refills, quantity, and days' supply of a prescription right away. If this is the case, to ensure your provider sent a prescription for the correct dose and days' supply, I recommend confirming this information by calling OptumRx directly.

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  • If it's too soon to refill your medication, OptumRx will let you know the earliest date when it can be billed to your insurance plan. In my experience, this has always been communicated via email, if you have these notifications turned on (I regularly receive text notifications on behalf of my OptumRx patients, but have never received this type of notification via text).

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  • Your active prescription(s) will be listed under My prescriptions in the grey navigation bar (prescriptions ready to refill are sometimes listed on your homepage as well). If a medication is in this list but displays a yellow “Eligible for Optum Home Delivery” label, there is no active prescription for that medication; rather, this is simply a placeholder for a medication you’ve billed to insurance within a prescribed period of time, and is a marketing strategy for encouraging you to move additional prescriptions to mail order. 

    • Technically, you can move these medications to mail order by clicking on them and then selecting Fill with home delivery, which will prompt OptumRx to reach out to your provider(s) on your behalf, but I’ve found that it’s better to contact your provider(s) personally and make the request yourself; they make take longer to respond to a request from OptumRx than one from you (especially if they've never sent prescriptions to them for you before), and sometimes clinics will not send an order to a new pharmacy without getting the patient’s verbal consent first (something, I've found, that doesn’t always get communicated to the patient, causing further delay).

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Refills

For future refills, you’ll place your order by finding the medication(s) you want to refill under My prescriptions (or possibly under Prescriptions ready to refill on your homepage), clicking on their name, and then selecting the dark blue Start refill button.

 

  • Moving forward, I recommend submitting refill requests 2 weeks before you're going to run out of medication (3 weeks if your prescription is out of refills or expired). This will give OptumRx plenty of time to bill your insurance and resolve any issues before shipping your medication to you. Don’t worry about submitting a refill request too early—if it’s too soon to fill per your insurance, OptumRx will set your order to begin processing as soon as your insurance allows.

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  • If your medication has a Prior Authorization (PA), it's helpful to note the PA's expiration date, since the PA expiring can also serve as a time-consuming hoop to jump through prior to the pharmacy being able to refill your medication. If you don't know the expiration date, you can confirm this by sending a secure message in your account or by calling your insurance plan directly using the number listed on your insurance or pharmacy benefit card.

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  • When you need a refill of a prescription that is now out of refills, you may not be able to add the prescription to your cart and check out like usual (it seems to depend on the plan); in that case, I'd recommend contacting your clinic directly to ask that they send a new prescription because the old one was out of refills (retail pharmacies would usually do this themselves, so if the clinic's confused you can explain that it's just easier this way for OptumRx specifically). You can also call OptumRx directly to request that they refill it, which will prompt them to reach out to your clinic for a new prescription, but I usually opt to call a patient's clinic directly (partly because it's almost always easier to reach/communicate with a clinic, despite this sometimes being difficult these days, and partly because clinics commonly don't follow up on requests from pharmacies).

 

  • I DO NOT recommend placing any prescription on autofill (i.e., it being filled regularly and automatically without your consent). Once medications are shipped to a patient from a mail order pharmacy, they are non-returnable and non-refundable, with few exceptions (the only situation I've encountered where a return was accepted was when the mail order pharmacy made a mistake). To avoid receiving medication that you don’t need, use tools like calendar reminders to keep track of when it’s time to order your next refill. Yes, it's tedious, but it will save you from receiving medication you don't need and/or can't afford.​

    • Per Medicare law, patients with Medicare insurance are not allowed to autofill medications, as it can lead to a wasteful accumulation of medication that patients don't need, but Medicare still paid for. In my experience, most mail order pharmacies still display this as an option in Medicare patients' accounts, and this is true for OptumRx; to confirm whether this setting is actually usable, you'll have to reach out to them directly (since I don't autofill my patients' medications, I'm unfamiliar with what happens when you try to turn this setting on for a Medicare patient).

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Tips for working with OptumRx

  • Logging into OptumRx always requires two-step verification, either via text or phone call. Although they provide the option for their website to trust your browser so that you wouldn't have to do this each time, I've never successfully been able to get this feature to work despite extensive troubleshooting. 

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  • Their website commonly experiences technical glitches. In my experience, this has included a blank screen or error message upon logging into your account and not being able to trust your browser, even when you check the applicable box upon sign in (see above). If refreshing the page, clearing your browser cache and cookies, or using an incognito window doesn't fix the issue, I usually just plan to try again later (if it's not urgent) or use their smartphone app (if it's urgent).

    • ​As of 1/1/2024, there’s been an ongoing problem with the OptumRx website requiring individuals to attempt signing into their account twice before successfully logging in. Additionally, the recent ransomware attack on 2/21/2024 on Change Healthcare (a subsidiary of UnitedHealth Group, OptumRx’s parent company) has caused further and ongoing technical issues. If you try signing in and get an error message after entering the verification code that was emailed or texted to you, simply repeat the process and it’s likely to work the second time; if not, try giving it some time (if it's not urgent) or using their smartphone app (if it's urgent).

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  • Their messaging center can come in handy in certain situations (calling them can be an arduous process for several reasons), but be aware that it's a somewhat poorly designed tool. Operators clearly use canned responses to answer the majority of questions, which oftentimes doesn't provide a helpful or even on-topic response. Additionally, the layout of the messages due to the use of these canned responses often leaves a lot of negative space amidst the small type that even I have a hard time reading. For these reasons, I haven't extensively used this tool. Giving them a call can also be an arduous process (from my experience, it appears at least some of their operators are located outside the US), and I've commonly experienced phone calls where I felt like I was "talking to a brick wall." So, with this mail order service I try my hardest to problem solve using only my notes, a patient's account, and calling the clinic (if applicable); then, if needed, I'll call OptumRx directly. While I don't usually enjoy my experience chatting with them, I will say that I'm usually connected with an operator quickly.​ When calling OptumRx for assistance, repeatedly saying that you want to “speak with an advocate” will help you get connected to an operator. Also, they offer a callback feature if you don’t want to wait on hold.

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  • It’s not uncommon that OptumRx will require your verbal consent before filling a medication for you for the first time. If you receive a call from them or get a notification that your order has been “canceled,” sometimes this is why. However, if asked by an operator if you want to remove this requirement for consent from your profile, explain to them that you don’t want them filling things automatically for you, if that's an available setting in your account. Having to field a phone call from them for new prescriptions is better than being sent and paying for medication that you don’t need.

    • This can also be true when, at the beginning of the year, your copay is higher than usual if you haven’t met the deductible on your plan (if your plan has one). Even though the OptumRx website makes it seem like you can acknowledge this higher-than-usual copay and consent for them to continue processing and ship your order, I've confirmed (the hard way) that you MUST CALL them to provide verbal consent over the phone; otherwise, your order will continue to be delayed and, ultimately, canceled due to “non-response” from you. â€‹â€‹â€‹

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  • If you ever get a notification that your order’s been “canceled” or “can’t be fulfilled,” always login to your account to see for yourself what’s going on. In short, I've received a wide variety of different kinds of notifications from OptumRx on behalf of patients that have simply been inaccurate (and after hundreds of phone calls with them, I have yet to figure out why this happens or how to prevent it). The status of any current orders can be found by clicking on Order status in the grey navigation bar (active orders also appear on your homepage). If you need further assistance, call OptumRx directly at (800) 356-3477 and ask to "speak with an advocate."​​​​​​

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  • OptumRx offers several speeds at which your prescriptions to be delivered. Standard shipping is free (including for medications with specific shipping guidelines set by the manufacturer, such as refrigerated items that must be shipped next-day), but shipping may be expedited on any prescription order, per your request. However, keep in mind that shipments only move on the “business days” of Monday through Friday (sometimes Saturday) and upgrading your delivery method does NOT speed up the processing of your prescription orders while they're still moving through the OptumRx mail order facility.

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  • OptumRx has a smartphone app available for free for both iOS and android devices. However, I find their website easier to use unless you're simply submitting a refill request.

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  • I've experienced a few of my patients being automatically enrolled in autofill by OptumRx without giving their consent. THIS IS ILLEGAL and can be turned off by logging into your account and disabling autofill for any medications they’ve done this for. If this happens to you, please consider filing a complaint with the Minnesota Department of Commerce (or the appropriate office in your state) or, if you’re a Medicare patient, the Centers for Medicare and Medicaid (CMS) so that they are made aware that PBMs are doing this. Click here for instructions on how to do this.

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