VPP Benefit Guide 2026-2027

For 2026, your pharmacy coverage will be RxBenefits , administered by OptumRx. Your joint medical and pharmacy ID card will be delivered to your home address. RX Benefits with Meritain PRESCRIPTION BENEFITS

How RxBenefits and OptumRx help you save on prescriptions

Function

OptumRx

RxBenefits

Manages pharmacy benefits for health plans and employers

Optimizes pharmacy benefits for employers and their employees

Role

Provides member services, helps members find lower-cost alternatives, assists with transitions of care Greater discounts, enhanced access, and improved member services for employers and their employees

Negotiates discounts with pharmacies, develops formularies, processes claims

Services

Lower prescription drug costs for health plans and employers

Benefits

KEY DETAILS ABOUT PRESCRIPTION BENEFITS

What is a prior authorization? Some medications may need prior authorization (PA) before filling your prescription. This ensures the medication is suitable for your condition and covered by your pharmacy benefits, aiming for safety, effectiveness, and cost-efficiency. The RxBenefits PA Review Team handles reviews, with submissions via the online portal.

Access to My RxBenefits • View pharmacy benefits coverage • Download and email ID cards • View 18 months of pharmacy claims (including claims for eligible dependents) • Establish and manage communications preferences • Access to online PA status (if they have Enhanced Protect and if RxB is the reviewer) Access to OptumRx.com • Review medication tiers, drug pricing, local pharmacies, plan details, and ways to maximize benefits • New Members will need to make an account

For Questions or Concerns

Members can contact RxBenefitsMemberServices Monday through Friday 7:00 a.m. – 8:00 p.m. Central customercare@rxbenefits.com 800.334.8134

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