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Pharmacy

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.

Please contact us if you need help finding the drug list that applies to your plan.

Affordable Care Act Exchange Drug List

(for On/Off Exchange, Individual and Small Group Plans)

2020 – Affordable Care Act Exchange Drug List (PDF)

Commercial Drug Lists

A drug list, also called a formulary, is a list of drugs covered by Health Net. We update our drug lists often and they may change.

For some drugs, your doctor must get approval from us before you fill your prescription. This is called prior authorization. We may not cover the drug if you don't get approval.

To request prior authorization, your prescriber must complete and fax a Prior Authorization Form (PDF) to:

  • Commercial: 866-399-0929
  • Medi-Cal Pharmacy Benefit PA: 800-977-8226
  • Medi-Cal Medical Benefit Pharmacy PA: 833-953-3436

View Our Prior Authorization Guidelines

Once we receive the request, we will review it to see if it can be approved. If we deny the request, we will tell you why it was denied. We will also tell you how to appeal the decision.

Last Updated: 10/22/2021