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Santa Clara Family Health Plan (SCFHP) members can get their prescriptions from most chain and independent pharmacies in Santa Clara County.

To fill your prescription, show your SCFHP member ID card, your Medi-Cal Beneficiary ID Card (BIC), and your prescription to any network pharmacy.

Frequently asked questions

How do I find a network pharmacy?

Network pharmacies are listed in the following places:

If you need a printed copy of the directory mailed to you, fill out and submit this request form. Or contact Customer Service.

  • Medi-Cal members, call 1-800-260-2055 (TTY: 711) Monday through Friday, 8:30 a.m. to 5 p.m.
  • DualConnect members, call 1-877-723-4795 (TTY: 711) 7 days a week, 8 a.m. to 8 p.m.

What drugs are covered?

For information about which drugs are covered in your plan, please see the Drug Formulary. This is also called List of Covered Drugs or Drug List for short. The Formulary is listed in the following places:

DualConnect members, please visit the DualConnect Prescriptions & Part D page for more information.

What is a Drug Formulary and how is it used?

A Drug Formulary is a complete list of drugs covered by SCFHP. Both brand name and generic drugs are included. For brand name drugs, if the generic option is available, SCFHP requires the use of the generic drug.

Any drug that is not listed on the Drug Formulary is considered a non-formulary drug and requires prior authorization (pre-approval).

The drugs on the Drug Formulary are available at pharmacies within our network. A pharmacy is in our network if we have an agreement with them to work with us and provide you services. We refer to these pharmacies as “network pharmacies”.

See above on how to find a network pharmacy and what drugs are covered.

Attention Medi-Cal members, your prescription drugs are covered through Medi-Cal Rx.

Prescription drugs given by a pharmacy are covered by Medi-Cal Rx, a Medi-Cal FFS program. For more information about Medi-Cal Rx visit

If you are eligible for both Medicare and Medi-Cal, Medi-Cal Rx may cover prescriptions Medicare does not, so you should talk to your doctor or pharmacy if you have any questions.

Medi-Cal Rx frequently asked questions

What will I need to take with me to the pharmacy?

Always bring your SCFHP ID card and your Medi-Cal Benefits Identification Card (BIC) with you when you go to the pharmacy. The pharmacy will use the card to look up your information and give you your medications.

What if I have more questions?

If you have questions about your medication or other pharmacy services, contact the Medi-Cal Rx Help Desk at 1-800-977-2273 or visit the website at

You can also email DHCS at Make sure to write that you have a question about Medi-Cal Rx. Please do NOT include personal information in your first email. DHCS staff will reply with a secure email asking for your information, if they need that information to assist you.

What happens if I have a Medi-Cal pharmacy benefit complaint?

Magellan (Medi-Cal Rx) will accept and resolve your complaint. You can submit a complaint either in writing or by telephone.

How can I appeal a Medi-Cal Rx benefit decision?

The California Department of Social Services has a State Hearing process if you want to appeal a pharmacy benefit decision. This process is different from the appeals process you may have used with your health plan. In a State Hearing, a judge reviews your request with clinical input from DHCS pharmacists to make sure the decision aligns with Medi-Cal pharmacy policy.

If a prescription is denied or changed, a form to request a State Hearing will automatically be sent to you with the notice of denial or change. If you do not agree with a denial or change related to your pharmacy services and benefits under Medi-Cal Rx, you can ask for a State Hearing. You can ask for a State Hearing by sending the State Hearing request form to:

California Department of Social Services State Hearings Division

P.O. Box 944243, MS 19-37

Sacramento, CA 94244-2430

You may also call to ask for a State Hearing by calling toll-free at 1-800-952-5253 (TTY: 1-800-952-8349). Please note that the number can be very busy so you may get a message to call back later.

You can get more information about the State Hearing Process by going to

You can also get the State Hearing request form by going to or by calling Customer Service at 1-800-977-2273 24 hours a day, seven days a week, or 711 for TTY Monday thru Friday, 8am to 5pm.