Two Things to Know About Your Prescription Drug Costs

Two factors that affect your cost for prescription drugs through the UC Blue & Gold HMO:

1. The formulary. A formulary is an extensive list of safe, effective medications covered by your Health Net plan. Generally, only drugs that are included on the formulary are covered. Learn more about the formulary (PDF).
2. The drug's tier. The UC Blue & Gold HMO formulary (PDF) is divided into three tiers plus specialty self-injectable medications. Your copays are based on the tier your prescribed drug is in.*

Find Your Prescription Costs

1. Gather the basic information from your prescription drug:
   1. Drug name (might be the brand name or the generic equivalent of a brand name)
   2. The strength prescribed (e.g., 10 milligrams)
   3. The daily dosage and treatment length (example: Take two 10 mg pills twice daily for 30 days)
2. Open the Health Net formulary (PDF):
   1. Press the CTRL+F buttons on your keyboard to search by name. In the small box that appears at the top or bottom of your screen, type the drug name and ENTER. You can also search by name by scrolling through the document.
   2. If the drug is on the formulary, the name will appear (a drug name may be repeated multiple times with different strengths, etc.). The shaded column shows the drug's tier (1, 2, 3 or specialty self-injectables).

Not covered? Drugs listed as Tier 7 are not covered by the plan. These are typically brand name drugs (shown in all CAPS) for which there is a generic equivalent (shown next to it in lowercase letters). Search instead for a generic equivalent to see if it's covered.

If your brand name prescription drug is not covered but its generic equivalent is, you may want to speak with your provider about changing your prescription drug to a safe and appropriate covered generic.

Skip the Trip to the Pharmacy

Use the CVS Pharmacy mail order service to get your prescriptions conveniently delivered to your home. To get started, ask your doctor to call in a new prescription to (800) 378-5697, or register or log in to Health Net. Select How can we help you today? Under My Prescriptions, choose Mail Order Drugs and follow the instructions.

_{* Without prior authorization from Health Net, there is no coverage for brand name drugs when a generic equivalent is available. If it is medically necessary for you to take a brand name medication when a generic equivalent is available, the prescription drug will be covered at the Tier 3 copay.}

_{Health Net of California, Inc. (Health Net) is a subsidiary of Health Net, LLC and Centene Corporation. Health Net is a registered service mark of Health Net, LLC. All rights reserved.}