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Rx CardFinder™ Services

This pharmacy eligibility service checks patient coverage with the nation’s largest pharmacy benefit managers (PBMs) and returns real-time responses.

What’s included in Rx CardFinder™ Services

Check member eligibility

Check member eligibility with leading PBMs

Benefits include:

  • Returns a real-time response to the pharmacy
  • Provides information including BIN, PCN, group number, cardholder ID, person code and processor helpdesk number
  • Options to send inquiries only to our Commercial Eligibility Partner or combined with our Medicare Part D Eligibility Partner

Coverage options

Determine additional coverage options

Benefits include:

  • Returns all eligibility information when multiple coverages are found
  • Informs pharmacy if no coverage is identified
  • Streamlines eligibility inquiries with a single transaction

Key benefits

Perform automatic, real-time eligibility inquiries for new prescriptions.

Automation streamlines workflows

Check member eligibility in real time using existing pharmacy management system workflows and improve your workflow with automatic inquiries for new prescriptions.

Technology identifies coverage information

Obtain coverage information for more than 270 million individuals and Medicare Part D enrollees with Rx CardFinder Services.

Customer service helps save staff time

Automation frees your staff to focus on enhancing other areas of the business. It also speeds workflows, helping enhance the patient experience.

Industry insights

Optum Rx: Relentless Prep, Strong 2026 Implementations

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Relentless preparation leads to a strong 2026 implementation

We delivered a seamless 1/1 transition for over 800 new clients with strong service, stable operations and improved member experiences.

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What plan sponsors need to know about WAC pricing shifts

The move to Maximum Fair Prices for popular drugs will trigger new economic considerations for plan sponsors.

Viewpoints on the 2027 CMS Advance Notice

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Viewpoints on the 2027 CMS Advance Notice

6 key proposed changes for 2027

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