Pharmacy Help Desk
The Pharmacy Help Desk provides 24/7 technical assistance to pharmacy staff to resolve claim questions.
Medicaid: 844-245-0449
Medicare: 866-325-7344
CareOregon Advantage Plus Formulary (drug list)
Prior Authorization and Step Therapy Criteria
Pharmacy policies
- CareOregon Advantage Prior Authorization criteria
- CareOregon Advantage Step Therapy criteria
- CareOregon Advantage opioid policies
- Authorization Guidelines - Injectable and Oncology Medications Administered by Provider (updated 6/1/2026)
- CareOregon (OHP) and CareOregon Advantage (Medicare) - Vaccine Coverage Guide
Pharmacy forms
- Injectable Medication Administered by Provider Authorization form
- Part D Vaccines Administered in the Medical Office Authorization and Reimbursement form
- Home Infusion Prior Authorization form
- Part D Redetermination form
If you are looking to submit a coverage determination or formulary exception for a drug dispensed at a pharmacy, submit your request through the OptumRx provider portal at https://professionals.optumrx.com/
For information on how to navigate the OptumRx website: OptumRx Provider tools (PDF)
You may also submit the Prior Authorization and Formulary Exception Request form (provided by Medicare) that OptumRx will review:
- Mail:
- OptumRx
- c/o Prior Authorization Department
- PO Box 2975
- Mission, KS 66201
- Fax: 503-416-8109
