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 $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 $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

Maintenance Drugs (For members utilizing mail order)

A maintenance medication is a prescription drug taken regularly to manage chronic or long-term conditions such as high blood pressure, asthma, diabetes, or high cholesterol.

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 navigation in the bullet above; click on Mail Order drugs; then download, print and send in the Mail Service Order Form.

Need Help? 

Health Net Customer Support