Medication & Pharmacy Information
Pharmacy Information
Introducing RealRx, our new Pharmacy Benefit Manager (PBM) created by 
University of Utah Health Plans and industry experts in an effort to bring our members and clients an improved experience. RealRx is designed to balance cost, convenience, and quality.
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**EFFECTIVE MAY 1, 2020**
Benefits prior to May 1, 2020, can be found here.
Pharmacy Customer Service is available at 1-855-859-4892. We provide 24 hours-7 days a week-365 day a year around the clock customer service, member portal access for pharmacy information, a large national network of pharmacies, and a national mail-order program with online tools and access.
- Pharmacy Benefits
- Find Medications on your Preferred Drug List (PDL) - Your plans use the U of U Health Plans Commercial Preferred Drug List (PDL) – Please note that the PDL is subject to change
- Search the Commercial PDL
- Review the Commercial PDL – pdf (*use “ctrl F” to search)
- Find a Pharmacy – U of U Health Plans uses a large national network of pharmacies
- In-Network Pharmacies
- U of U Health Pharmacies (Click the pharmacy option to view U of U pharmacy locations)
- 90 day supply can be obtained through University of Utah Health pharmacies, NoviXus Mail Order pharmacy, and in-network pharmacies for Tier 0, 1, 2, and 3 medications
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- Enroll in the Mail Order Program (through NoviXus Mail Order)
- NoviXus Mail Order Form (or call 877-668-4987 to get started)
- NoviXus Member Portal Login
- Enroll in the Mail Order Program (through NoviXus Mail Order)
- Member Information
- Member Pharmacy Portal: Access your pharmacy claim history, search for pharmacies, or view the formulary.
- RealRx Login (Contact Pharmacy Service to register)
- Member Pharmacy Portal: Access your pharmacy claim history, search for pharmacies, or view the formulary.
- Pharmacy Direct Member Reimbursement (DMR)
- If you have paid out of pocket for a prescription and are looking to be reimbursed through the plan, please contact Pharmacy Customer Service before submitting a DMR Form. Pharmacy Customer Service will work with you to contact your pharmacy to assist them in processing claims electronically. This is the quickest process as the pharmacy can refund you onsite. If the pharmacy is unwilling to submit electronically, then Pharmacy Customer Service will assist you in filing a DMR. (Please note: the DMR process can take up to 30 days to complete and does not include any network discounts that the pharmacy would have written off per contract.) Please contact Pharmacy Customer Service for questions or assistance in submitting a reimbursement request for a prescription.
- If you have paid out of pocket for a prescription and are looking to be reimbursed through the plan, please contact Pharmacy Customer Service before submitting a DMR Form. Pharmacy Customer Service will work with you to contact your pharmacy to assist them in processing claims electronically. This is the quickest process as the pharmacy can refund you onsite. If the pharmacy is unwilling to submit electronically, then Pharmacy Customer Service will assist you in filing a DMR. (Please note: the DMR process can take up to 30 days to complete and does not include any network discounts that the pharmacy would have written off per contract.) Please contact Pharmacy Customer Service for questions or assistance in submitting a reimbursement request for a prescription.
- Brand - Generic Charge
- Brand-Generic Charge is applied if you receive a Brand name drug, regardless of reason or medical necessity, or if your provider prescribes a Brand name drug when a generic is available. A Brand-Generic Charge is the difference in cost from the Generic to the Brand name drug. This charge is added to the regular cost-sharing outlined in your benefits summary. The Brand-Generic charge does not apply towards your Out-of-Pocket Max.
- Medications with Special Requirements – Some medications have special requirements (Quantity Limits, Prior Authorization, and Step Therapy) that must be met before U of U Health Plans will cover them. This process must be completed by your doctor before you can fill a prescription.
- Prior Authorization is needed for certain drugs listed on the preferred drug listed. In addition, all Specialty Medications (Tier 4) require prior authorization.
- Step Therapy is a type of prior authorization for medications that require your provider to first prescribe and you to try alternative options that are generally more cost-effective and that have proven effective for your condition before you can move up a “step” to a more expensive medication.
- Quantity Limits is a set maximum of a quantity a medication that a person may have covered under the plan within a certain period of time for safety and cost reasons.
To submit a Prior Authorization or an Exception Request, your provider can either print and fax the forms for review or submit the request online.
General Pharmacy Information
Pharmacy Customer Service: 855-859-4892
U of U Health Plans Pharmacy Processing Information
Bin: 610830
PCN: REALRX
Pharmacy Customer Service is available at 1-866-236-5930.
- Pharmacy Benefits
- Find Medications on your Preferred Drug List (PDL) - Your plans use the U of U Health Plans Commercial Preferred Drug List (PDL) – Please note that the PDL is subject to change
- Search the Commercial PDL
- Review the Commercial PDL- pdf (*use “ctrl F” to search)-
- Find a Pharmacy – U of U Health Plans uses a large national network of pharmacies
- Member Information
- Member Pharmacy Portal: Access your pharmacy claim history, search for pharmacies, or view the formulary.
- Portal Login (Contact Pharmacy Service to register)
- Portal Login (Contact Pharmacy Service to register)
- Member Pharmacy Portal: Access your pharmacy claim history, search for pharmacies, or view the formulary.
- Pharmacy Direct Member Reimbursement (DMR)
- If you have paid out of pocket for a prescription and are looking to be reimbursed through the plan, please contact Pharmacy Customer Service before submitting a DMR Form. Pharmacy Customer Service will work with you to contact your pharmacy to assist them in processing claims electronically. This is the quickest process as the pharmacy can refund you onsite. If the pharmacy is unwilling to submit electronically, then Pharmacy Customer Service will assist you in filing a DMR. (Please note: the DMR process can take up to 30 days to complete and does not include any network discounts that the pharmacy would have written off per contract.) Please contact Pharmacy Customer Service for questions or assistance in submitting a reimbursement request for a prescription.
To submit a prior authorization your provider can either print and fax the form for review or submit the request online.
- Submit an Exception Request - This is for exception requests for coverage of medications
General Pharmacy Information
Pharmacy Customer Service: 866-236-5930
U of U Health Plans Pharmacy Processing Information
Bin: 019843
PCN: UUHPRx
