Specialty, infused and injectable prescription drugs

Members requiring specialty medicines shown on the list below must use OptumRx Specialty Pharmacy to get their medicine. (This does not apply to our Fallon Medicare Plus, NaviCare, or Summit ElderCare members.)

We are committed to providing patients seamless access to their medications while delivering on high-value clinical touchpoints and improving overall clinical outcomes. For the very small percentage of cases where a limited distribution product cannot be provided by Optum Specialty Pharmacy, the limited distribution product can be filled at another participating pharmacy within the member's pharmacy network. Claims processing and billing activities are integrated to make the alternate vendor relationship transparent to Fallon Health members and physicians.

To get set up with specialty pharmacy, members can visit specialty.optumrx.com or call 1-855-427-4682.

To get set up with specialty pharmacy, visit specialty.optumrx.com or call 1-855-427-4682.

• See the specialty pharmacy drug list
• See the oncology split fill list