Pharmacy Benefit Program

The right medical treatment at the right time maximizes recovery. The employer, injured worker, and claims administrator all must work together to ensure quality medical care is received. Often, this includes prescription medication to achieve the best possible recovery for the injured worker.

The Helios/Optum Pharmacy Benefit Program makes it easy for employees to fill prescriptions without delay and has been proven to reduce Workers' Compensation claims costs. The program includes a network of pharmacies and established "formularies" or list of pre-approved medications. This means employees receive the right medicine for their specific injury, from the pharmacy they choose.

How does it work?

The temporary “First Fill” form is completed by the employer and provided to the employee along with the DWC-1.

After visiting the doctor, the employee provides the First Fill form to the pharmacy along with their first prescription. The prescription is automatically approved, eliminating potential delays and out-of-pocket costs for the employee. Within a few days, the employee will receive a claim-specific prescription card to cover any future prescriptions. For injuries that require long-term treatment, employees will be eligible to have prescriptions delivered right to their home.

Members can find the First Fill form on the Documents tab of the Member Dashboard. If you have any questions or concerns about this program, please call us at 800-400-2642.



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