First Quarter 2025 Drug Coverage Updates

Date: 10/25/24

This update applies to Health Net Health Plan of Oregon, Inc. "Health Net" Commercial Plans.

Prior Authorization Changes to Physician-Administered Medication
See the table in the First Quarter 2025 Drug Coverage Updates document (PDF) for a list of new HCPC codes. These codes now require prior authorization for coverage for Health Net Commercial Plan members.

Quarterly Update on Drug Coverage Guidelines
See the table in the First Quarter 2025 Drug Coverage Updates document (PDF) for all the updated or new Health Net coverage guidelines that were approved by the Pharmacy and Therapeutics Committee in the fourth quarter of 2024. All coverage guidelines will go into effect January 1, 2025 and will become available to view in their entirety on our website approximately two weeks prior to the effective date.

Additional Information
For questions regarding the information contained in this update, please contact the Health Net Pharmacy Department at 1-888-802-7001.