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Home Healthcareplans Cal MediConnect Prescriptions & Part D

Prescriptions & Part D

Prescriptions & Part D

As an SCFHP Cal MediConnect member, you can fill your prescription at over 250 pharmacy locations in Santa Clara County or by mail-order.

SCFHP will usually cover your drugs as long as you follow the rules:

  • You must have a doctor or other provider write your prescription. This person often is your primary care provider (PCP).
  • You generally must use a network pharmacy to fill your prescription.
  • Your prescribed drug must be on the plan’s List of Covered Drugs (Formulary), also called the Drug List. For certain prescription drugs, special rules limit how and when the plan covers them.
  • If it is not on the Drug List or it has special rules, we may be able to cover it by giving you an exception. For more information, see Coverage Decisions & Exceptions.
  • Your drug must be used for a medically accepted indication. This means that the use of the drug is either approved by the Food and Drug Administration or supported by certain reference books.

For more information on your prescriptions and Part D benefits and services, click the + buttons below or refer to the SCFHP Cal MediConnect Member Handbook and List of Covered Drugs available on the Member Materials page in multiple languages.

If you would like to make a complaint or appeal, or file a grievance, go to the Complaints, Appeals & Grievances page.

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