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Our formulary or drug list is a list of covered drugs selected by Health Net, along with a team of health care providers. These drugs are selected because they are believed to be a necessary part of a quality treatment program. Health Net covers both brand name and generic drugs. Our formulary is updated regularly, so make sure to look up your prescriptions before you choose a plan. There is no guarantee that any specific drug included on the formulary will be prescribed for a particular medical condition.
|Plan||Formulary Name||Printable PDF|
|Health Net Gold Select (HMO), Health Net Healthy Heart (HMO) in Fresno, Los Angeles, Orange, Riverside, and San Bernardino counties, Health Net Seniority Plus Amber I (HMO SNP), Health Net Seniority Plus Amber II (HMO SNP), Health Net Seniority Plus Ruby (HMO) in Kern, Los Angeles, Orange, Riverside, and San Bernardino counties, Health Net Violet (PPO) in Sacramento and San Diego counties||2014 Classic Formulary||
|Health Net Jade (HMO SNP)||2014 Jade Formulary||
|Health Net Healthy Heart (HMO) in Alameda, San Diego, San Francisco, Stanislaus, and Yolo counties, Health Net Healthy Heart Plan 1 (HMO), Health Net Healthy Heart Plan 2 (HMO), Health Net Ruby Select (HMO), Health Net Seniority Plus Ruby (HMO) in Contra Costa, San Diego, Santa Barbara, Santa Clara, Santa Cruz, San Joaquin, Solano, and Sonoma counties, Health Net Violet (PPO) in Placer, San Francisco, San Joaquin, Stanislaus, and Yolo counties||2014 Value Formulary||
|All Employer Group Medicare Part D Plans||2014 Employer Group Formulary||
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.
Our pharmacy network includes more than 67,000 pharmacies. All network pharmacies may not be listed in the pharmacy locator. A pharmacy's listing in the pharmacy locator does not guarantee the pharmacy is still in our network. Pharmacies may have been added or removed from our network. We also list pharmacies that are in our network but are outside your plan's service area.
Health Net's contracted pharmacy network meets or exceeds the Centers for Medicare and Medicaid Services requirements for pharmacy access. Beneficiaries must use network pharmacies to access their prescription drug benefit. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each calendar year.
|Pharmacy Directory Name||Printable PDF|
|2014 CA Pharmacy Directory||
With our nationwide network of pharmacies, it's easy to get your prescriptions filled using your pharmacy benefits. However, we understand you may not always be able to use a network pharmacy. We will cover prescriptions filled at an out-of-network pharmacy in certain situations. This may include:
Before you have your prescription filled in these situations, call Customer Service to check if there is a network pharmacy in your area that can fill your prescription.
In most cases, your claim will be automatically submitted when you have your prescription filled at a network pharmacy. However, if you go to an out-of-network pharmacy, they may not submit the claim directly to us. In these cases, you must pay the full cost of your prescription upon receipt. You may then submit a Health Net Medicare Prescription Claim Form to request a reimbursement of our share of the cost.
Mail the completed form and receipts to the address listed on the form. Once we receive your claim, we will mail our determination with a check, if applicable, to you within 14 days.
Refer to your Evidence of Coverage for specific information about drug coverage and limitations. If you have questions about this process, please Contact us.Health Net Medicare Prescription Claim Form
Information last updated 09-13-2013
To provide you with the most accurate plans and information in your area, we need to know your location. Please enter a ZIP code for Arizona, California, Oregon, Washington.
To provide you with the most accurate plans and information in your area, we need to know your location. Please enter a ZIP code for Arizona, California, Oregon, or Washington.