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Mail this completed order form with your new prescription(s) to Optum Rx, P.O. Box 2975, Mission, KS 66201. Do not staple or tape prescriptions to the order form.
Optum® Home Delivery Pharmacy is a full service mail order pharmacy with the convenience of delivering medications directly to your home. Benefits include free standard shipping, 24/7 pharmacist access and more.
Complete an order form and mail it with your written prescription(s) to Optum Home Delivery Pharmacy. Prescription order form (PDF) (743.42 KB) For more information about Optum Home Delivery Pharmacy, visit the Optum Rx Education Center .
Please order at least 21 days before you need your medicine. Online – Go to the My Medicine Cabinet page and have copayments charged to a credit card. By Mail – All orders are mailed with a reorder form. Just check the medications you want to refill and mail the form back to our mail order pharmacy, along with a check or your credit card ...
Order prescriptions, get drug pricing information, pay your bill, locate a pharmacy, manage your health information and more. Optum Rx can help.
OptumRx Form Downloads. Optum® Home Delivery mail-order form – English (pdf) Optum® Home Delivery mail-order form – Spanish (pdf) Claim form – Commercial (pdf) Claim form – Medicare Part D (pdf) Tools. Pricing and coverage tool. Find a network pharmacy. Prescription Drug List.
Mail this completed order form with your new prescription(s) to Optum, P.O. Box 2975, Mission, KS 66201. Do not staple or tape prescriptions to the order form.