How to look up prescription drug prices
Need to fill a prescription? There are quick ways to check which medications are covered by your plan. You can also see if there are out-of-pocket costs you may need to pay. Follow these steps to easily look up your medications online and see prices:
- Sign in to your member site
- Go to Pharmacies & Prescriptions
- Choose Drug Pricing
- Search or choose the medication to get drug pricing
Ready to fill your prescriptions?
After you’ve checked your coverage, you’re ready to fill your prescriptions. Here’s what to know.
Will the Inflation Reduction Act (IRA) affect my prescription drug coverage?
In 2025, Medicare plan members will experience a change in coverage as a result of the Inflation Reduction Act (IRA). This law aims to reduce out-of-pocket costs for prescription drugs for Medicare members. Your coverage and costs may change because of this law, so it’s important to understand the details.
How can I save on prescription drugs?
When it comes to saving on medications, here are a few tips to help you get the most for your money — and use your benefits to the fullest.
What are prior authorization and coverage requirements?
Some prescription drugs may have limits or require extra steps before it can be filled. This extra step is typically in place for safety reasons.
How do I know if my medication requires prior authorization?
On the drug list, medications that require prior authorization or have coverage requirements may have a code by them. Here are examples of the codes you may see:
- PA: Prior authorization. You or your health care provider need prior approval for a drug, to make sure it is being used correctly for your health condition.
- ST: Step therapy. You may be required to use another effective, lower-cost medication for your condition first.
- QL: Quantity limit. The plan may limit the amount of a drug you can fill at one time to make sure that it is used safely and effectively.
What should I do if my medication requires prior authorization?
If your drug has one of these requirements or limits, your provider will need to provide more information to fill the prescription. Your provider may also choose to change your prescription to another medication. You may be allowed to fill the prescription one time as a transition. This gives you time to work with your doctor or pharmacy to get the help you need. If this happens, contact your doctor or pharmacy.
Want to see if your drug has an authorization or coverage requirement? Sign in to the member site and look up your drug under Drug Pricing.
Are there other prescription drug plan options?
If you have a stand-alone Part D plan, another option is an all-in-one Medicare Advantage prescription drug plan.1 Medicare Advantage plans often:
- Offer the same drug coverage, but with lower premiums and copays
- Combine your doctor, hospital and prescription drug coverage, all in one
- May include extras like vision, dental and hearing benefits, plus rewards, discounts and more
Frequently asked questions about prescription drug coverage
A drug list or formulary is a list of medications that shows how they’re covered by your plan. If you have a prescription for a certain kind of medication, you can look it up in your plan formulary to see how it’s covered. Plans may add or remove specific prescription drugs from their drug lists from year to year.
Yes, there is a $0 copay for most Part D covered adult vaccines, including the shingles vaccine.2
If you’re keeping an eye on your health care costs, it might be a good idea to talk to your provider about switching from a brand name to a generic drug that treats the same condition. Generics have the same active ingredients found in brand-name versions — and are just as safe and effective, according to the U.S. Food and Drug Administration. This could save you hundreds of dollars per year, according to the Centers for Medicare & Medicaid Services.
Optum Home Delivery Pharmacy is a convenient, cost-effective option for medications you take regularly. Here are some of the benefits of choosing this option:
- Medications are delivered directly to your door, which means fewer trips to the pharmacy.
- Pharmacists are available by phone 24 hours a day, 7 days a week to answer questions.
- You can set up automatic reminders to help you remember when to take your medication and refill your prescriptions.
You can fill prescriptions at any network pharmacy. If you’re traveling and away from your home pharmacy, sign in to your member site to find the closest pharmacy and contact the pharmacy to fill your prescription.