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Prescriptions

Prescription medications are an important part of one's healthcare requirements, which is why we focus so much attention on the subject.

For our health plans, we maintain a "drug formulary" -- a large list of the most common medicines that Santa Clara Family Health Plan doctors use. These medications have been chosen for their quality, safety and cost. A group of doctors and pharmacists regularly review the list to ensure it includes any newly available medications.

The latest copy of the formulary (as a pdf) is available for viewing/downloading via the link to the right.

For a hardcopy of the Formulary, please contact Member Services at 800-260-2055.

Filling a Prescription

To fill a prescription, simply visit any Santa Clara Family Health Plan contracted pharmacy. Prescription pic Be sure to take both your prescription and your Santa Clara Family Health Plan ID card to the pharmacy.

SCFHP contracts with most local chain and independent pharmacies that operate within Santa Clara County. To find a contracted pharmacy near you, use the SCFHP Healthcare Facility Search utility.

Should you have questions regarding the filling of a prescription, contact our Member Services.

When Issues Arise

Prescription issues don't occur very often, but when they do, they usually fall into one of the following categories.

My doctor says I need a medication that's not on the list.Pills pic The list of medications in the formulary is extensive, but every so often the particular medication required is not on the list. When this happens, your pharmacist and your doctor need to request approval prior to writing/filling such a prescription. Ask your doctor to submit a "Drug Prior Authorization Request" form (available for download by providers).

My pharmacist says I have to pay full price for my prescription. If this happens, be sure the pharmacist has seen your Santa Clara Family Health Plan ID card. If you don't have your card, ask the pharmacist to call our Eligibility Verification department at 1-800-260-2055. This will let he or she know that you are a Santa Clara Family Health Plan member.

My pharmacist says my prescription is not covered under my plan. If this happens, the pharmacist should contact the health plan or our Pharmacy Benefit Manager.