Injectable Medication Coverage Policy
Provider Type
- Physicians
- Participating Physician Groups (PPG)
Injectable medications, including those for therapeutic purposes, are covered when authorized by the Pharmacy Services or in accordance with the Health Net Provider Participation Agreement (PPA) Division of Financial Responsibility (DOFR).
Prior authorization must be obtained through the Pharmacy Services for self-injectable medications, including antihemophilic factors and human growth hormone (HGH).
Refer to the Benefits/Injectables Prior Authorization topic for additional information. For specific information about specific plan and employer group exceptions, refer to the Schedule of Benefits.