My Pharmacy Coverage

OptumRx administers the pharmacy benefit for UC SHIP and has a nationwide network of retail pharmacies that includes the student health center (SHC) pharmacy.

How your pharmacy coverage works

  1. When you need a prescription filled, start at the SHC pharmacy, if your campus has one. You can fill prescriptions from SHC clinicians and other doctors outside the SHC. Prescriptions filled at the SHC will have the highest UC SHIP coverage, which means you’ll pay less for them. You can also fill your prescriptions at any OptumRx network pharmacy by showing your Anthem member ID card. The OptumRx network includes retail pharmacies like CVS and Walgreens. Sign in to the OptumRx website to view a full list of network pharmacies in your area.
  2. Your cost (copayment) will be based on whether the drug is a generic, brand-name formulary, brand-name non-formulary or specialty medication. A formulary is a list of medications that UC SHIP covers. You can find a link to the formulary on the Plan Documents page.
  3. What you pay for prescription drug costs counts toward your annual out-of-pocket limit. Once your costs reach that limit, UC SHIP steps in to pay 100% of your pharmacy costs.

You’ll pay more at an out-of-network pharmacy

If you fill your prescription at an out-of-network pharmacy, you will need to pay the entire amount of the prescription and then submit an OptumRx prescription drug claim form (pdf) for reimbursement. The pharmacist must complete and sign the claim form to ensure the claim is properly processed. Your reimbursement will be considerably less than what you paid for the medication.

Download the OptumRx app to manage your prescriptions

On the OptumRx app, you can check prices, find local pharmacies and view your prescription history. Download OptumRx for Android devices on Google Play or OptumRx for iOS devices on the App Store.

Pharmacy benefits at a glance

Use the links below to jump to a summary of your campus’s prescription benefits. For more details, review the OptumRx Pharmacy Plan Booklet; there’s a link to it on the Plan Documents page.

UC Davis pharmacy benefits
UC Hastings pharmacy benefits
UC Irvine pharmacy benefits
UC Los Angeles pharmacy benefits
UC Merced pharmacy benefits
UC Riverside pharmacy benefits
UC San Diego pharmacy benefits
UC San Francisco pharmacy benefits
UC Santa Barbara pharmacy benefits
UC Santa Cruz pharmacy benefits

Make sure your prescriptions are covered 

Please consult the formulary (pdf), available on the Plan Documents page, for the list of covered prescription drugs. Certain prescription drugs are not covered by UC SHIP.