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UPREHS pharmacy benefits

Refill Prescriptions Online
To refill prescriptions on the UPREHS website you must login to the secure member section of our website. To access this are you must first create a member login account, login and then access the appropriate link to fill or refill a prescription. Refill Prescription Now >

Pharmacy Benefits & Formulary for Active Members

The UPREHS Pharmacy Program is designed to meet the specific needs of members and provide excellent outpatient prescription drug benefits. Benefits are limited to physician prescribed drugs and medications used for the treatment of a medical condition that is a covered benefit. Member cooperation is vital to the success of the pharmacy program. Failure to use the program consistently in the manner required can result in denied benefit payment. Members are responsible for denied payments.

The UPREHS formulary is a list of outpatient prescription drugs and other medications that are an allowed benefit when used for the treatment of a medical condition that is a covered benefit. The formulary is incentive based, which means there are three Tiers with the lowest member copayments applying to the least costly drugs. The higher the cost of the drug to UPREHS, the higher the Tier and member copayment. Formulary prescription drugs are included in Tier 1 and Tier 2. Most non-formulary prescription drugs are available under Tier 3. Tier 3 pharmacy benefits eliminate the need for most appeals, special medical review, and exceptions to the formulary.

UPREHS Mail-Order Pharmacy copayments are less than when using the UPREHS or contract network pharmacies. Using the UPREHS Mail-Order Pharmacy whenever possible is most economical for you and UPREHS. The Pharmacy and Therapeutics Committee reviews the formulary at least three times each year. Formulary content is based on these reviews so drugs may change during the calendar year. If you have questions about current prescription drugs or prescription benefits you may call UPREHS Customer Service at 1-800-547-0421 between the hours of 7:30 AM and 3:30 PM Mountain Time, Monday through Friday. The current UPREHS Formulary List is available in the Forms / Publications section of the website.


Pharmacy Benefits and Formulary for Retiree Members

This is a service that will be coming soon. Please keep checking this area of the website for more news and information about this upcoming benefit.
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