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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.

Pharmacy benefits at-a-glance

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

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 there. 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 medical ID card. The OptumRx network includes retail pharmacies like CVS or Walgreens. Sign in to the OptumRx site 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 review the UC SHIP formulary on the “Plan Docs” 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 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. You can download the OptumRx app from the Apple App Store or Google play.

Pharmacy benefits at-a-glance
Here is a summary of your share of costs when you order prescriptions. You'll find more details in the OptumRx Pharmacy plan booklet on the “Plan Docs” page.

Make sure your prescriptions are covered
Please consult the UC SHIP formulary for the list of covered prescribed drugs. Certain prescribed drugs are not covered by UC SHIP. See the Exclusion List.