Pharmacy Benefits

The WTC Health Program has partnered with Team MCA (Managed Care Advisors & Optum) to provide prescription benefits for members with certified WTC-related conditions. Their national pharmacy network offers ease of access to over 65,000 retail pharmacy network locations including all major pharmacy chains, independent outlets, national clinics, and compounding pharmacies. A convenient mail order program allows members with certified WTC-related conditions to have their medications delivered directly to their home. Optum’s pharmacy services are built on best-in-class programs that ensure convenience and safety for members.

Pharmacy Updates

  • September 1, 2018 – Starting on December 1, 2018, the WTC Health Program will limit the types of over-the-counter products that will be covered by the Program. Learn more
  • April 25, 2018 – The home delivery pharmacy provider changed from Walgreens to OptumRx (non-specialty medicines) and BriovaRx (specialty medicines). Learn More

For Survivors: Coordination of Benefits

Survivors in the WTC Health Program are required by the James Zadroga 9/11 Health and Compensation Act to have all prescriptions billed to primary insurance first before they are billed to the WTC Health Program. This is known as “Coordination of Benefits”. Learn more about how this works and what you need to do on the Coordination of Benefits page.

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Still have questions?

Visit the Frequently Asked Questions (FAQs) or call Optum at 1-855-640–0005. You can also learn more by visiting the Pharmacy Benefits section of the Member Handbook