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A formulary or drug list is a comprehensive list of covered drugs selected by Health Net in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Health Net will generally cover the drugs listed on the formulary as long as the drug is medically necessary, the prescription is filled at a Health Net network pharmacy, and other plan rules are followed. The fact that a medication is listed on our formulary does not guarantee that your physician will prescribe it for you for a particular medical condition. Since the formulary is updated regularly, the information may change during the year.
Selecting a Formulary
To determine which formulary applies to your plan, locate your plan name or plan type in the table below. If you are not sure of your plan name, you can find it on your Evidence of Coverage.
|Plan Name or Type||2012 Formulary Name||Printable PDF|
|Health Net Orange Option 1 (PDP)||Value Formulary|
|Health Net Value Orange Option 2 (PDP)||Value Formulary|
|Health Net Orange Option 2 (PDP)||Classic Formulary|
|All MAPD Medical Plans (HMO, PPO, and POS)||Classic Formulary|
Exceptions to the Formulary
If your drug is not covered on our formulary or has restrictions or limitations, you can ask for a formulary exception. Learn more about requesting an exception.
Explanation of Benefits
When you use your Part D prescription drug benefits, Health Net will send you an Explanation of Benefits to help you understand and keep track of payments for your Part D prescription drugs. The Explanation of Benefits is member specific and is available for free in another format or language upon request. To request this document in another format or language, please call Customer Service.
View Medicare Part D Step Therapy Criteria:
View Medicare Part D Negative Formulary Changes:
View Health Net's Medicare Part D Transition Program
Information last updated 12/06/2011