Frequently Ask Questions

• When is my benefit transitioning to Optum as the preferred provider for home delivery and specialty pharmacy fulfillment?

  Your pharmacy benefit plan is transitioning to Optum Home Delivery and Optum Specialty Pharmacy on January 1, 2024.

• When will I receive information about this transition?

  Capital Rx has prepared a communication plan to keep you informed of transition changes.

  • 60 Days Prior to Transition: Those who are currently filling medications with Walmart Mail Order and/
    or Specialty Pharmacy will be sent a notice of change letter in the mail. This will detail the change taking
    place and outline any next steps.
  • 30 Days Prior to Transition: All cardholders will be sent an informative postcard in the mail regarding the
    transition to Optum.
  • 21 Days Prior to Transition: Members currently filling medications with Walmart Mail Order and/or Specialty Pharmacy will receive a call from Capital Rx to remind them of the transition to Optum.
  • 14 Days Prior to Transition: Members currently filling medications with Walmart Mail Order and/or Specialty Pharmacy will receive a call from Optum to offer support with registration or with requesting a new prescription from your prescriber.
• What if I have an open prescription with Walmart Mail Order or Specialty Pharmacy?

  Capital Rx is working closely with Walmart Mail Order and Specialty Pharmacies to transfer eligible prescriptions to Optum Home Delivery or Specialty Pharmacy. Prescriptions that are expired, controlled substances, or prescriptions that do not have any remaining refills cannot be transferred. If you need support with requesting a new prescription from your prescriber, please contact Capital Rx by dialing the number listed on your ID card and follow the prompts for either medications delivered to your home or specialty pharmacy.

• Will I need a new prior authorization given this change in pharmacy?

  No. Your prior authorization status is maintained by Capital Rx and will not change from what was originally approved.

• Will I need a new ID card?

  No. The information listed on your ID card for your pharmacy benefit will remain the same.