SFHP Formulary
The San Francisco Health Plan Formulary is a list of medications reviewed and approved by our PBM’s Pharmacy and Therapeutics (P&T) Committee. They select products on the basis of their safety, efficacy, and quality. SFHP’s P&T Committee will review the formulary and is comprised of actively participating network providers and pharmacists. Providers are requested to prescribe medications included in the formulary whenever medically appropriate.
For Medi-Cal Rx’s formulary, also known as the Contract Drugs List (CDL) please visit Medi-Cal Rx’s homepage, under Tools and Resources.
SFHP Healthy Workers HMO Formulary
Searchable Formulary, Printable Formulary (PDF format) Posted 03/09/2026
HW Specialty Drug List (PDF format) Posted 03/09/2026
HW Vaccine Drug List (PDF format) Posted 02/01/2026
Preventive Drug List (ACA) (PDF format) Posted 02/01/2026
Physician Administered Drugs Covered Under Healthy Workers HMO Outpatient Pharmacy Benefit (PAD) (PDF format) Posted 02/01/2026
Step Therapy Edits
San Francisco Health Plan has Step Therapy (ST) medications listed on formulary. These drugs will process at the point of sale at the pharmacy, if the required medications have been tried and failed with paid claims. If paid claims do not exist, a prior authorization request must be submitted for consideration of coverage.
Specialty Pharmacy Requirements
The Specialty Drug List reflects medications designated as specialty drugs under the pharmacy benefit. The drugs with this requirement are designated with “SP” on the formulary.
Most specialty drugs require a prior authorization. If covered, the specialty drugs cannot be obtained from a network retail pharmacy and must be obtained from a MedImpact contracted mail order specialty pharmacy.
The MedImpact Direct Specialty Program will help members set up their specialty medication delivery with a contracted mail order specialty pharmacy. The prescriber can send the prescription directly to MedImpact Direct Specialty via fax at 1(888) 807-5716. The contracted specialty pharmacy that will fill the medication will contact the member to set up their account and to arrange the delivery of the medication.
Members can also contact MedImpact Direct Specialty Program directly to get assistance in setting up an account with a specialty mail order pharmacy and transferring an existing prescription:
Phone: 1(877) 391-1103 (TTY dial 711)
Email: [email protected]