Pharmacy
Pharmacy Benefit Information
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 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)
Prescriptions
Go to any participating pharmacy to obtain a 30-day prescription of medication. If you take a prescription on a daily basis consider signing up for mail order pharmacy.
Cost saving tip: Get generic alternatives to brand-name medications.
Mail order pharmacy
With the mail order program, you can reduce your out-of-pocket costs by getting a three-month supply of your maintenance prescription drugs, usually at a lower copayment. Maintenance drugs are those taken on a daily basis to treat chronic or long-term conditions. There are several ways to get started:
- By phone – Have your doctor call in a new prescription to the mail order pharmacy at 1-800-378-5697 or fax to 1-800-378-0323.
- Online – Register or log in, Click How can we help you today? Under My Prescriptions, click on Mail Order drugs and follow the instructions to request a new prescription.
- By mail – Follow the Online navigation; select Mail Order drugs; then download, print and send in the Mail Service Order Form.