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Specialty pharmacies

What is a specialty pharmacy?

A specialty pharmacy delivers medicine and treatments to patients with complex, chronic or rare medical issues. These medicines usually cost over $1,000 for a 30-day supply. They often need special storage and handling such as refrigeration. A specialty pharmacy helps your patient get their medicine quickly. It also provides extra support for you and your patient.

What if my patient needs a specialty medicine?

Some specialty medications require prior authorization. You can get prior authorization by calling OptumRx at 800-711-4555.

If you request prior authorization for a specialty medicine by fax, please use a drug-specific form.

Optum Specialty Pharmacy

Optum Specialty Pharmacy is the specialty pharmacy for the Culinary Health Fund. Patients can enroll in the specialty drug program by calling 855-427-4682. Culinary Health Fund participants can only get their specialty medicine from Optum Specialty Pharmacy.

If your patient needs a specialty medicine, Optum Specialty Pharmacy will:

  • Navigate the prior authorization process
  • Provide thorough education about all of the medicines they offer, including injection instruction
  • Offer fast, free home delivery of your patient’s medicine
  • Provide proactive refill reminders
  • Help you manage your patient’s side effects
  • Maintain close contact with you to keep you informed of your patients’ progress
If a drug isn’t available, Optum Specialty Pharmacy will let you or your patient know where to go.

How much will it cost my patients?

Specialty prescription costs vary based on the drug. If your patients need a specialty drug on our variable copay program, they may pay up to 25% of the cost. There’s also a secondary manufacturer savings program available for specialty prescriptions.

Sending a prescription to Optum Specialty Pharmacy

You can fax, e-prescribe, or call Optum Specialty Pharmacy to send in a prescription.

How do my patients get their prescriptions from Optum Specialty Pharmacy?

Your patients can have their prescription delivered to their home or your office for free.

  • Your patient or their authorized representative will be required to schedule the delivery.
  • UPS will deliver the medicine.
  • Your office will only be contacted regarding a prescription shipment if you’re injecting or infusing the drug on-site.
Your patient may be able to get next-day delivery, or even same-day delivery by courier. Call Optum Specialty Pharmacy at 855-427-4682 for details.