Plan Details
Plan Materials
- Northern California – FEHB benefits brochure (PDF)
- Southern California – FEHB benefits brochure (PDF)
Download the PDF for your records or you can call 1-888-926-1692 to request a printed copy to be mailed to you.
Summary of Benefits and Coverage
Northern California
Southern California
Pharmacy Benefits
Health Net plans give you generic, brand and specialty tier coverage. The easy-to-use pharmacy programs offer the convenience you want with the value you're looking for.
To determine the cost of a drug, use the formulary list below to identify the drug and the tier under which it is covered. Below are the copays by tier for each of the plans available. To view detailed cost information of a drug by plan option, please click on the Check Drug Cost & Coverage links under the second column below.
| Retail prescription drugs | Generic/brand/non-formulary/specialty |
|---|---|
| High Option | $10/$35/$60/20% ($200 max) Check Drug Cost & Coverage |
| Standard Option (Southern CA) | $15/$35/$65/20% ($200 max) Check Drug Cost & Coverage |
| Basic Option (Southern CA) | $15/$35/$65/20% Check Drug Cost & Coverage |
| Basic Option (Northern CA) | $15/$30/$50/20% Check Drug Cost & Coverage |
| Mail order prescription drugs | Generic/brand/non-formulary |
|---|---|
| High Option | $20/$70/$120 |
| Standard Option (Southern CA) | $30/$70/$130 |
| Basic Option (Southern CA) | $30/$70/$130 |
| Basic Option (Northern CA) | $30/$60/$100 |
Our drug lists are selected by Health Net, along with a team of health care providers. These drugs are included because they are believed to be a key part of a quality treatment program. The drug lists are updated regularly and may change.
Commercial Drug List
3-Tier with specialty drug list (PDF)
Other Information
- Craving to Quit® program - Quit your tobacco habit today!
- Glossary of health coverage and medical terms (PDF)
- MinuteClinic® Reference Guide (PDF)