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.

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.

Our drug lists are updated frequently. If you can't find your drug on our drug list, always Contact Us and ask if your drug is covered.

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: dosage, strength, safety, quality, the way it works, the way it is taken and the way it should be used.