Letter Of Agreement Specialty Pharmacy

For most UnitedHealthcare products, self-injected/injectable drugs are generally excluded from medical coverage. A pharmacy driver can provide coverage for a self-injected/injectable drug. This exclusion from medical benefit does not apply to self-administered/injectable drugs due to their characteristics defined by UnitedHealthcare, typically administered or monitored directly by a qualified physician or certified healthcare professional in an outpatient environment. We may refuse all or part of any claim arising from the use of non-participating specialist pharmacists, wholesalers or direct purchase from manufacturers by you or any other healthcare professional, without prior authorisation from us. You may also be subject to other administrative measures, as provided for in your agreement. Our National Pharmacy & Therapeutics Committee regularly reviews and updates our pharmaceutical policies for these drugs…

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