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As a Healthy Workers HMO member, prescription medications are part of your health plan benefits. When you need medication, your Primary Care Provider will prescribe it.

Be sure to tell your healthcare provider that you have a preferred pharmacy so your prescriptions can be sent to the correct pharmacy location. To get your medications, show your San Francisco Health Plan Member ID Card to the pharmacy staff at your preferred pharmacy.

For more information or to see if a specific drug is covered under the Healthy Workers HMO program call SFHP Customer Service at 1(415) 547-7800 or 1(800) 288-5555 toll free.

What is a drug formulary?

SFHP has a drug formulary. The drug formulary is the list of drugs that SFHP will pay for. Even if a drug is listed on the SFHP drug formulary, your doctor may choose not to prescribe it for your particular condition. The formulary also includes Preferred and non-Preferred drugs. The co-payment for preferred drugs is $5 (generics) and the co-payment for non-Preferred drugs is $10 (brands).

Refer to your Healthy Workers HMO Evidence of Coverage and/or Summary of Benefits and Coverage for more information on your prescription medicine benefits. If you want to see if your prescription medicine is covered, refer to the San Francisco Health Plan Drug Formulary.

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