Pharmacy Coverage

Employees enrolled in the medical plan will automatically receive prescription drug coverage through OptumRx. You will receive a prescription drug card to be used at participating local pharmacies. Franklin County Cooperative Health Benefits Program offers mail order through OptumRx. Both retail and mail order options are available. You save both time and money by obtaining your ongoing routine prescriptions through the Mail Order Program. You can also save on your copay expense by using generic medications.

COVID-19 Information

Benefit change: Effective September 1, 2024, COVID-19 test kits will no longer be available on the Optum Store using your health insurance. This means that you will have to pay out of pocket for any test kits ordered at Optum Store after September 1, 2024.

Vaccines & Boosters

Science has shown that vaccines and boosters are the best method of protecting yourself, your family, and your community against COVID-19 infection, serious illness, and death. COVID-19 vaccines and boosters are available at no cost at in-network pharmacies or at an in-network medical provider. Coverage at an OON medical provider is available subject to coinsurance, deductible, and balance billing. OON pharmacy coverage is not available.

Testing

If you are enrolled in the Franklin County Cooperative health plan, you can obtain up to 8 at-home tests per member per month through your pharmacy benefits. Coverage depends on where the test kits are purchased.

Where can I purchase a COVID-19 test kit?

Test kits can be purchased at the pharmacy counter (not the front counter) of the following pharmacies:

  • Rite Aid
  • Sam's Club
  • Walmart
  • Walgreens

Effective September 1, 2024, COVID-19 test kits are no longer available on the Optum Store using your health insurance. You can still purchase test kits on the Optum Store but will be charged the full cost.

What do I need to present?

Your OptumRX ID card at the pharmacy counter. Ask to have your test kits submitted to your pharmacy plan. A written prescription from your doctor is not needed. If you are a registered user at optumrx.com, replacement cards as well as a temporary id card can be requested online.

How much is covered?

There is 100% coverage (up to $12 per test) for up to 8 self-test kits per member, per month

What do I need to submit to OptumRx?

Nothing.Your tests are covered 100% at the pharmacy counter.

Treatment

COVID-19 treatment is covered just as any other service, i.e. applicable copays and deductibles apply.

Frequently Asked Questions

Find the answers to frequently asked questions.

If you have any questions regarding coverage for COVID-19 vaccines, tests, or treatment, contact the Benefits Office at 614.525.5750.

Documents

 

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