Mail-order pharmacy program

When you use our mail-order pharmacy program, you don’t have to leave the house to get your prescription–it’s delivered right to your door. The shipping is free to anywhere in the United States. 

Who can use our mail-order pharmacy program?

You can use mail order if you've been on the same medication for several months with no change in dose, and you plan on being on the same medication and dose for a while.

How to fill new prescriptions using mail order 

• Ask your doctor to fax or electronically send a new prescription to OptumRx. As long as your provider is contracted with the plan, they'll have all of the information they need to do this.
  
  
• Call OptumRx at 1-844-657-0494 (TRS 711) and they'll ask you for your medication and prescriber information, and other information they may need to process your prescription.
  
  
• Go online to optumrx.com. (This link takes away from the NaviCare website.) Register (if you haven’t already) and once you log in, go to "My prescriptions."
  
  
• By mail. You can mail your prescription and mail-order form to:
  OptumRx
  PO Box 2975
  Mission, KS 66201

Make sure your doctor writes your mail-order prescription for a 100-day supply.

How to get refills

We suggest that you request a refill within 7-10 business days from the day you're going to run out of your medication. You have the option to sign up for an automatic refill program. Under this program we will start to process your next refill automatically when our records show you should be close to running out of your drug. The pharmacy will contact you prior to shipping each refill to make sure you need more medication, and you can cancel scheduled refills if you have enough of your medication or if your medication has changed.

You can also: 

• Sign up to order refills online at optumrx.com. (This link takes you away from the NaviCare website.)
• Call toll-free at 1-844-657-0494 (TRS 711).
• Request refills by mail—with each mail-order prescription you'll receive a refill slip with a pre-addressed return envelope that can be mailed in.

Pre-packaged medications

You can also have a 30-day supply of your medications individually packaged and labeled by dose, date, and time. Each pack is clearly labeled morning, midday, evening, and/or bedtime. There is no cost, and they can be delivered right to your home. To find out more about this program, call Enrollee Services at 1-877-700-6996 (TRS 711), 8 a.m.–8 p.m., Monday–Friday (7 days a week, October 1–March 31).

Frequently asked questions about mail-order pharmacy

Q. How much time do I need to give between ordering a refill and needing to receive it?
A. We suggest that you request a refill within 7-10 business days from the day you're going to run out of your medication.

Q. Can I order a refill as soon as I receive my last shipment?
A. No. You can't order a refill until you've used up 83% for most drugs, 83% for opioid drugs, or 70% for topical ophthalmic drugs of your current shipment. For a 100-day supply, this means for most drugs you can order a refill when you have about 17 days left of your current shipment.

Q. What medications are available through mail order?
A. Only certain medications are available through mail order. On your formulary (drug list), the last column will be marked with MO if the medication is available through mail order. Please remember that your prescription must be written for a 100-day supply. Please note that opioid medications are only available in a 30-day supply.

Q. Can I get over-the-counter medications through mail order?
A. You can get medications that you have a 100-day supply prescription for and that are listed on your formulary (drug list) as available through mail order. In addition, if you have a prescription for a covered over-the-counter medication, you may also get that through the mail-order pharmacy. These medications are listed on your NaviCare® SCO and NaviCare® HMO SNP Over-the-Counter and Additional MassHealth Covered Drugs List.

Q. What happens if my medication needs to be refrigerated and it’s delivered on a hot day?
A.  We pack medications requiring refrigeration in insulated boxes (or coolers). Additionally, a combination of frozen and ambient gel packs are included with the order, depending on the destination temperature. Should you receive your medication and it is warm, call OptumRx at 1-844-657-0494 (TRS 711) and report the problem. Our team of trained pharmacists and clinicians will gather information from you to determine the condition/safety of the medication order. If it is determined the medication is damaged, or is at risk of being unsafe, a new order will be shipped to you. OptumRx can also help you get an emergency 30-day supply at your local pharmacy.

Q. What happens if I’m on vacation? Can I get it delivered somewhere else?
A. Yes, as long as you call OptumRx before you ask for your refill, you can have your prescription mailed to you anywhere in the United States.

Q. What happens if someone steals my medication?
A. If your medication is lost or stolen, you should call OptumRx at 1-844-657-0494 (TRS 711) and ask for a refill. You can also get a 30-day supply at your local pharmacy. For both situations, the pharmacy must call Fallon Health for an early refill override and explain that it's due to a lost or stolen medication.

Q. What if I run out of my medication before the next shipment arrives?
A. You can get a 30-day supply at your local pharmacy. The pharmacy must call Fallon Health for an early refill override and explain that it's due to a mail-order delay.

Q. What does the package look like? Will my neighbors know that I am getting a box with medications?
A. The package is discreet to maintain confidentiality. It doesn't mention OptumRx.

NaviCare is a voluntary program in association with MassHealth/EOHHS and CMS. To view the PDF files above, you may need to download a free copy of Adobe^® Acrobat Reader software on your computer. (This link takes you away from the NaviCare website.)  Adobe^® is a registered trademark of Adobe Systems Incorporated.

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The information on this page was last updated on 10/1/2024.