The subscriber number can be found on your Health Net Insurance card. Please enter the complete ID, including all letters and numbers. All letters must be typed as capital letters.
3-Tier Pharmacy Benefit
Health Net offers a prescription program with comprehensive drug coverage. Drug coverage is limited to drugs listed on this Drug List. The Drug List was developed by the Pharmacy and Therapeutics Committee, with involvement and recommendations from physicians, pharmacists, and other health care professionals. In addition to clinical considerations, the Committee evaluates the treatment costs of therapeutically equivalent pharmaceuticals. Development and maintenance of the Drug List is a dynamic process. The Drug List is continually reviewed and revised in response to recommendations from participating physicians and as new clinical data and pharmaceuticals become available.
The Drug List only applies to outpatient prescription drugs. It does not apply to inpatient drugs (hospital, skilled nursing facility or nursing home) or to drugs obtained from and/or administered by a health care professional.
FlexRX 3-Tier Copay Benefits
Drug coverage for plans with FlexRX 3-tier copay benefits (for example $10 for preferred generic drugs, $20 for preferred brand name drugs and $40 for non-preferred drugs), are also subject to the Health Net Drug List.
Under these benefits, preferred generic drugs are available at the lowest copayment level. Preferred brand name drugs are available for a higher copayment. Non-preferred drugs are available at the highest copayment level. In addition, there are prior authorization requirements for select drugs on the Drug List. For these drugs and drugs not included on the Drug List, a physician may request a patient specific authorization. Requests for these drugs are evaluated to determine if the established approval criteria are met.
For more information regarding your pharmacy benefit, contact Health Net Customer Service at 1-800-289-2818. The TTY Customer Service number for the hearing impaired is 1-800-977-6757.