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:

  1. Submit the prior authorization electronically through CoverMyMeds which is Health Net's preferred way to receive prior authorization requests.
  2. Complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) and submit to Pharmacy Services.
  3. Contact Pharmacy Services directly via telephone.