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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.
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 .
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.
• Order up to a 3-month supply. • Get your medications delivered right to your mailbox — with free standard shipping. • Talk to a pharmacist 24/7. Submit your order one of 3 ways: Visit welcome.optumrx.com/uawford to learn more today. All Optum trademarks and logos are owned by Optum, Inc. in the U.S. and other jurisdictions.
Optum Rx 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) Step Therapy Exemption Form (pdf) Prior Authorization Request Form including Fax Number (pdf) Tools. Pricing and coverage tool.
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.
2 Οκτ 2024 · 1. Get started. Select Optum Home Delivery at checkout or transfer your current medication from your prescription details page. 2. Get it filled. After Optum Home Delivery receives your order, they will reach out to your prescriber or pharmacy to get your prescription. 3. Get it delivered.
