Pharmacy
Your pharmacy benefits will be provided through OptumRX until December 31, 2025. Starting January 1, 2026, they will be managed by CVS Caremark.
Know your drug coverage
We designed this Pharmacy Benefits Member Guide to help you easily understand your coverage and make the most of it. Inside, you'll also find smart ways to save on prescription costs. Because plans can vary, be sure to check your Evidence of Coverage for specific coverage details.
Pharmacy benefits are covered through a CalPERS direct contract with OptumRx. After you enroll, you will receive an ID card from Health Net which will include your medical benefits and OptumRx info.
For complete pharmacy listings and details on what's covered, call OptumRx at 855-505-8110 or visit the OptumRX web page.
| Pharmacy | Generic | Brand formulary | Non-formulary |
|---|---|---|---|
| Retail pharmacy | $5 | $20 | $50 |
| Mail order pharmacy | $10 | $40 | $100 |
| Pharmacy | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
| Retail Pharmacy (up to a 30-day supply) | $5 | $20 | $50 |
| Retail Pharmacy (up to a 90-day supply of maintenance medication) | $10 | $40 | $100 ($70 copyament with an approved Partial Copay Waiver) |
| CVS Caremark® Mail Service Pharmacy (up to a 90-day supply of maintenance medication) | $10 | $40 | $100 ($70 copyament with an approved Partial Copay Waiver) |
| Specialty Pharmacy (up to a 30-day supply) | $5 | $20 | $50 |
Note: Effective January 1, 2026, your pharmacy benefits will be covered through a CalPERS direct contract with CVS Caremark. For complete pharmacy listing and coverage details, call CVS Caremark at 833-291-3649 or visit CVS Caremark Pharmacy Benefits for CalPERS.
Note: the CVS Caremark phone number and web address will not be available until September 15, 2025.
Get your FREE blood glucose meter for Health Net members
Find out how you can get your FREE blood glucose meter.
Check first with your doctor, diabetes educator or pharmacist to find out which meter is right for you. Then, take advantage of this offer by calling one of the following telephone numbers. A new meter will be mailed to you at no charge. Call to get your blood glucose meter and start paying lower copays on test strips, right away!
- For an Abbott Diabetes Care meter, call toll-free: 866-224-8892
- For a OneTouch® meter, call toll-free: 855-872-6391