All About Pharmacy
We created this Pharmacy Benefits Member Guide to make it easier for you to understand and get the most from your pharmacy benefit coverage. It will also give you important cost-saving options. Since some plans may differ from others, you'll want to Log in to access your coverage documents for details about your specific plan benefits.
FEHB 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.
Cost-saving tips
- Choose generic drugs when possible
- Use our mail order pharmacy for maintenance prescription drugs.
Mail Order Service
With our mail order pharmacy – CVS Caremark®, you can receive up to a 90-day supply of your maintenance prescription drugs for a lower copayment cost. These are medications you take on a daily basis that are needed to treat a chronic or long-term condition.
The CVS Caremark® website offers you the ability to check the status or balance of an order, request a prescription transfer from a retail pharmacy, update personal information, and pay for your order online all within a secure portal. Our preferred mail order service allows you to:
- Order up to a 90-day supply of drugs (excluding Specialty).
- Enjoy free standard shipping, safely and discreetly to your door.
- Save time and make fewer trips to the pharmacy.
- Set-up auto refill and renew mail order service at no extra cost.
You may order your medication one of the following ways:
- Phone: CVS Caremark® Member Services at 888-624-1139 (TTY: 711) 24 hours a day, 7 days a week.
- Online: Visit the Caremark website
- Mail: Complete the CVS Caremark® form below and send it to the address listed on the form.
CVS Caremark Forms:
To learn more, please refer to your plan's Evidence of Coverage. Members may also call the number on the back of their member ID card.