Optum Rx Fax Numbers
Optum Rx routes by request type: one line for a Part D appeal, another for a coverage determination or prior authorization. Send yours free from your phone.
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Appeal or coverage determination, and why it matters
Optum Rx separates the two requests that look similar from the outside.
A coverage determination asks Optum Rx to cover a drug in the first place, or to make an exception to a formulary rule. That goes to the Prior Authorization Department, fax (844) 403-1028.
An appeal contests a decision Optum Rx has already made. For Part D it is called a redetermination. That goes to the Appeals Coordinator, fax (877) 239-4565.
Sending an appeal to the prior-authorization line restarts your request in the wrong queue, and so does the reverse. Read the letter you received: it says which decision it is, and therefore which line comes next.
What to include
For either request, Optum Rx asks for:
- Member name and date of birth, and the Medicare Part D member ID number
- The name of the medication, with the strength and quantity
- Your physician’s name, phone number, and fax number
- For an appeal, the reason you believe the decision was wrong, plus the coverage-determination letter
- Any evidence supporting the request, including a statement from the prescriber
A request form plus a prescriber statement is typically two to four pages, which sends free within your monthly free pages.
Getting the answer, not just the send
Part D decisions come back in writing, and expedited ones often come by fax to the number the request came from. Part D timelines are measured in days rather than weeks, so a determination you never receive is one you cannot act on.
A dedicated FaxTerra number receives replies as PDFs in your FaxTerra inbox with an email notification. See how receiving works.
How to fax Optum Rx without a fax machine
Create a free FaxTerra account with an email address, upload the form and any prescriber statement as a PDF or as phone photos, enter the Optum Rx line that matches your request, and send. Track delivery so you have a timestamp against the deadline.
See how to send a fax for accepted files and page limits, the UnitedHealthcare guide for the medical side of the same coverage, and how to fax an insurance claim for the general appeal process.
See how to send a fax with FaxTerra
Frequently Asked Questions
What is the OptumRx fax number?
Optum Rx publishes (877) 239-4565 for a Part D appeal or redetermination, and (844) 403-1028 for a coverage determination or prior-authorization request.
What is the difference between a coverage determination and an appeal?
A coverage determination is the first request, asking Optum Rx to cover a drug or grant an exception. An appeal contests a determination that has already been made. For Part D it is called a redetermination. They go to different departments and different fax numbers.
Can my doctor submit the request instead?
Yes, and for a prior authorization it is usually faster. Prescribers can submit through the Optum Rx professional portal or by phone. You can file a coverage determination or an appeal yourself as well.
What if Optum Rx denies my appeal?
A denied Part D appeal moves to an independent review entity, and the denial letter tells you where to send that request. That reviewer is not Optum Rx, and the address is different.
Is FaxTerra affiliated with Optum Rx?
No. FaxTerra is an independent online fax service. We deliver your document to the number you enter and confirm when it arrives. We cannot see your prescription coverage or the status of a request.