We're here to answer any questions you have about your Health Net plan. Do you have a concern that isn’t addressed in our Frequently Asked Questions?
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Show your Health Net ID card at the pharmacy every time you get a prescription drug.
Search the Pharmacy Locator to find a network pharmacy or call Customer Service.
Refer to your plan documents or member handbook for a full description of your benefits.
When you have a prescription to fill, keep these tips in mind:
Some covered drugs require prior authorization or have coverage restrictions or limits. This means that you must receive approval from Health Net before the drug will be covered. If your doctor or pharmacist tells you that a prescription drug is not covered, or has coverage restrictions or limits, your doctor may request prior authorization or an exception.
If your drug requires prior authorization, talk to your doctor about other drugs for your condition that are on our drug list. If there are no other drugs, your doctor may request prior authorization for your drug from Health Net.
For some drugs, we only cover a specific amount of the drug. If a drug has a quantity limit, your doctor must request prior authorization for a higher amount to be covered.
Yes. If your prescription is due while you're on vacation, we will cover an early refill if you or your pharmacy lets us know. You are responsible for any additional copayment that applies and the refill is limited to one month. You may also use our mail order pharmacy to receive up to a three-month supply.
Yes. Our mail order pharmacy is generally used for maintenance drugs.
Our drug lists are updated frequently. If you can't find your drug on our drug list, always call Customer Service and ask if your drug is covered.
A compounded drug is made by a pharmacist because the manufacturer does not make it in a certain strength or with certain ingredients. These prescriptions may require prior authorization. Please call Customer Service for questions about compounded drug coverage.
Our drug list, or formulary, 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. Our drug lists are updated regularly and are subject to change. There is no guarantee that any specific drug included on the drug list will be prescribed for a particular medical condition.
If you have paid out-of-pocket for a drug, you may be eligible for reimbursement (minus your copayment) on prescriptions filled for emergency medical care.
Your pharmacy benefit covers insulin, lancets, needles, syringes, and blood glucose test strips. Although these items are available over-the-counter, you must have a prescription for the pharmacy to process the claim.
A generic drug is the same as a brand-name drug in:
Yes. The United States Food and Drug Administration (FDA) requires that all drugs are safe and effective. Generic equivalent drugs use the same active ingredients as brand name drugs and work the same way.
Yes. Unless specifically told not to do so by you or your doctor, network pharmacies may substitute a generic drug for a brand name drug.
Yes. FDA requires generic drugs to be equal to brand name drugs in quality, strength, purity, and stability.
No. Generic drugs work in the same way and in the same amount of time as brand name drugs.
Yes. Generic drugs will act the same way as brand name drugs. Be sure to discuss all the drugs you take with your doctor or pharmacist to ensure you have no adverse reactions.
No. All factories must meet the same high standards. If the factories do not meet certain standards, FDA will not allow them to make drugs or be sold in the U.S.
No. New brand name drugs have a patent when they are first made. Most drug patents are protected for several years. The patent protects the company that originally made the drug. The patent does not allow another drug company to make and sell the drug. When the patent expires, other drug companies can start selling the generic version of the drug after it has been tested and approved by the FDA.
Developing a new drug is very expensive. Since generic drug companies do not develop a drug from scratch, the costs to bring the drug to market are less. Generic drug companies, however, must show that their drug acts in the same way as the brand name drug. The FDA approves all generic drugs before they are released to the public.
Generic drugs are proven to be safe, effective and typically cost much less than brand name drugs. By choosing generic drugs, you can save money without compromising quality.
Talk to your doctor or pharmacist for more information about generic drugs.
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.