Updates to pharmacy prior authorization and step therapy requirements
Update
Last modified: Feb. 1, 2025
Update: Added information about Florida.
Effective Jan. 1, 2025, unless otherwise noted, Optum Rx® will manage prior authorization and step therapy requests for prescription medications using UnitedHealthcare clinical criteria. This applies to members of Golden Rule Insurance Company plans that have prescription benefits administered through Optum Rx in the following states:
- Alabama
- Arkansas
- Colorado
- Florida (effective March 1, 2025)
- Iowa
- Kansas
- Kentucky
- Maryland
- Michigan
- Mississippi
- Nebraska
- Nevada
- Ohio
- Oklahoma
- South Carolina
- Tennessee
- Virginia
- Wisconsin
- West Virigina
- Wyoming
Requesting prior authorization
To request prior authorization, please use either of these options:
- Online: Visit the Prior authorization for prescribers page
- Phone: Call the Optum Rx prior authorization team at 800-711-4555
Checking benefits in real time
PreCheck MyScript® allows prescribers to easily run pharmacy trial claims and get prescription coverage details for UnitedHealthcare members.
Questions?
If you have questions, please call Golden Rule at 800-657-8205 and press option 2 for the provider line.
PCA-1-24-03781-Clinical-NN_01102025