Using OptumRx for Prescriptions

Publish Date
- 12:17 pm

Beginning January 1, 2023, Tufts Health Plan is partnering with a new Pharmacy Benefit Manager (PBM), OptumRx, to administer our pharmacy benefit. 

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. HMO members: visit to search for in-network pharmacies. PPO members: visit

Using Home Delivery with OptumRx
Prescriptions have been transferred to OptumRx Home Delivery for members who used CVS Caremark mail order to fill prescriptions in 2022 and have open refills. 

Members can register for an account at to set up refills going forward. 

Members who don't register online, will receive a phone call from OptumRx this month asking if they would like to continue with home delivery. If yes, they will request that the member registers for an OptumRx account and provides updated payment information.

As a reminder, CVS is still an in-network retail pharmacy.

For members not using Home Delivery – they can sign up and save

Home delivery prescription ordering delivers medications that members refill each month right to their home. Depending on their plan, members may be able to save up to $53 by using home delivery for a 90-day supply of prescription medications (depending on the tier their drug is on). That’s a potential savings of up to $212 a year! Learn more about home delivery. 


New Preferred Pharmacies
With the switch to OptumRx, Walmart, Rite Aid, and Stop & Shop pharmacies will be part of our preferred pharmacy network beginning January 1, 2023. 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.

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.

If you have any questions, please contact Medicare Broker support:  
Call: 1-833-984-2387.