Pharmacy

Important Update

Starting January 1, 2024, California Health & Wellness Plan will no longer serve Medi-Cal members. The information and resources provided on this webpage are applicable to services rendered on or before December 31, 2023.
 

If you are a provider in Amador, Calaveras, Imperial, Inyo, Mono, or Tuolumne counties, who is part of the Health Net provider network starting January 1, 2024, please visit Health Net for services rendered on or after January 1, 2024.

The Pharmacy Program at California Health & Wellness is designed to provide access to pharmacy services to our members, and to ensure that these services are a covered benefit, medically necessary, appropriate to the member’s condition, rendered in the appropriate setting, and meet professionally recognized standards of pharmacy care.

Drug list

Medication Prior Authorization Requests

Your pharmacy benefit is administered by Medi-Cal Rx, and they are responsible for your authorizations.

To request prior authorization, the prescriber must complete a Prior Authorization Form and fax it to 800-869-4325.

Self-Administered Non-Specialty Medications

Your pharmacy benefit is administered by Medi-Cal Rx, and they are responsible for your authorizations.

To request prior authorization, your prescriber must complete a Prior Authorization Form and fax it to 800-869-4325.

Self-Administered Specialty Medications

Your pharmacy benefit is administered by Medi-Cal Rx, and they are responsible for your authorizations.

To request prior authorization, your prescriber must complete a Prior Authorization Form and fax it to 800-869-4325.

Physician-Administered Specialty Medications

California Health & Wellness Pharmacy Department

The California Health & Wellness Pharmacy Department handles prior authorization requests for medications that will be administered by a provider (i.e. biopharmacy, home health, outpatient, injectable or infusible medications).

Fax: 1-877-259-6961
Phone: 1-877-658-0305

NOTE: Enteral Nutrition

  • Submit Pump Enteral Nutrition Prior Authorizations to California Health & Wellness Pharmacy Department. Billing must be through California Health & Wellness Medical Billing.
  • Bolus (no pump) Enteral Nutrition:
    • If self-administered and billing under Pharmacy benefit, must be handled through Medi-Cal Rx.
    • If billing under Medical Benefit, submit Prior authorizations to California Health & Welness Pharmacy Department.

Find a Pharmacy

To find a pharmacy you can use the Find a Pharmacy tool.