Pharmacy Network Change – and New Preferred Pharmacies

Publish Date

At Tufts Health Plan we are always looking for ways to improve the benefits and services we provide. To improve how our members get medications, beginning January 1, 2023, Tufts Health Plan is partnering with a new Pharmacy Benefit Manager (PBM), OptumRx, to administer our pharmacy benefit. 

What is a PBM?
Tufts Health Plan partners with a Pharmacy Benefit Manager (PBM) to administer our pharmacy benefit. PBMs provide many pharmacy services to members, including claims processing, contracting with the pharmacies in our network, and much more. 

What are the advantages of OptumRx?
We made the decision to switch to Optum Rx to improve how members get the medications they need.  The OptumRx retail pharmacy network has more than 67,000 pharmacies nationwide, including CVS Pharmacy and many others that Tufts Health Plan members currently use. Use the links below to search for an in-network pharmacy near you.

HMO Pharmacy Locator

PPO Pharmacy Locator

Senior Care Options (HMO-SNP) Pharmacy Locator

New Preferred Pharmacies
Beginning January 1, 2023, Walmart, Rite Aid, and Stop & Shop pharmacies will be part of our preferred pharmacy network! Wegmans will no longer be a preferred pharmacy but will continue to be in our pharmacy network. This means members may pay more for their prescription at Wegmans.  

Note: Preferred pharmacy benefit doesn’t apply to HMO Prime Rx and HMO Prime Rx Plus plans.  

Specialty Medications
Starting January 1, 2023, members who use any specialty medications have the option to fill their prescription with our new preferred specialty pharmacy, Optum Specialty. To learn more, visit CVS Specialty will continue to be in our network, so members can keep their prescription there, if desired.