Self-Injectable Medications
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Self-administered medications, as determined by Health Net, include, but are not limited to, medications cited by the Food and Drug Administration (FDA) as a self-injectable, orally, or topically administered medications and specifically packaged by the manufacturer to be administered by the member in an outpatient environment or at home. Self-injectable medications can be administered subcutaneously or intramuscularly with a syringe and needle. The administration routes must be proven safe and effective when self-injected by the member.
Prior Authorization for these self-administered medications can be obtained by faxing a request to Medi-Cal Rx at 800-869-4325 or by using CoverMyMeds®.
There are three options for submitting a prior authorization form:
- Submit the prior authorization electronically through CoverMyMeds which is Health Net's preferred way to receive prior authorization requests.
- Complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) and submit to Pharmacy Services.
- Contact Pharmacy Services directly via telephone.