26-122 Expanded Shingrix Vaccine Coverage Now Available at Contracted Pharmacies
Date: 02/06/26
In-office administration remains an option for participating physician groups
To improve member access and reduce avoidable coverage issues at the point of care, Health Net is expanding coverage for the Shingrix® vaccine to include contracted pharmacies. This change allows patients ages 50 and older to receive the vaccine at more convenient locations while ensuring consistent coverage across settings. Participating physician groups (PPGs) may continue offering Shingrix in-office as an alternative option.
Effective date | Line of business |
|---|---|
January 1, 2026 | Individual & Family Plans (HMO and PPO) |
February 15, 2026 | Employer Group Plans (HMO, PPO, Elect Open Access) |
What this means for your patients
- Improved access: More options to get the Shingrix vaccine.
- $0 copay: Covered as a preventive medication under the pharmacy or medical benefit.
What this means for your practice
- Fewer coverage issues: Prevents situations where patients are referred to a pharmacy only to learn the vaccine isn’t covered.
- Greater flexibility: PPGs can continue to administer Shingrix in-office or refer patients to contracted pharmacies when the provider or practitioner’s supply is limited and/or unavailable.
- No capitation deduction.
How to locate contracted pharmacies for your patients
When referring a patient to a contracted pharmacy for the Shingrix vaccine, you can verify participating pharmacies using:
- Health Net’s online provider directory — search for contracted pharmacies by name, location or plan. Go to Find a Provider.
- The pharmacy search tool — identifies pharmacies contracted for the patient’s specific plan. For patients enrolled in:
- Individual & Family Plans, go to Find a Pharmacy.
- Employer Group plans, go to Employer Plan Pharmacy Benefits.
For assistance confirming pharmacy participation, contact the contracted pharmacy.
Using these resources helps ensure your patients are referred to pharmacies that can provide the Shingrix vaccine at the $0 copay level.
Need help? Contact us
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the Health Net provider portal.
Provider Services
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO |
This information applies to Physicians, Practitioners, Participating Physician Groups (PPGs), Hospitals, and Ancillary Providers.