If the drug you searched is not in the formulary or has the initials NF, PA, QL or ST next to it, then complete the Prescription Drug PAR Form and fax it to HPSM at 650-829-2045.
Learn more about prior authorizations for prescription drugs.
Call the Pharmacy Unit
For more information about a formulary, coverage rules, or authorizations, call 650-616-2088.
Search the Formulary
The medications HPSM covers are listed in each plan's formulary. You can find out if HPSM covers a medication by searching the formulary that corresponds to the member's health plan.
Use the formulary search form for your patient's health plan to find a covered drug by generic or brand name, or view all drugs within a category. For CareAdvantage and HealthWorx HMO, the links below also contain information about upcoming and prior formulary changes.
Order a printed formulary
If you would like an ACE, CareAdvantage, or HealthWorx formulary mailed to you, email or call HPSM. For Medi-Cal, call the Medi-Cal Rx Customer Service Center at 1-800-977-2273.
Order by email
Send the following information to formularyrequests@hpsm.org:
- Your first and last name
- Daytime phone number (in case we need to call you about your request)
- Mailing address
- Which program's formulary you are requesting (ACE, CareAdvantage, or HealthWorx HMO)
Order by phone
- HealthWorx HMO, and ACE: 1-800-750-4776 or 650-616-2133
- CareAdvantage: 1-866-880-0606 or 650-616-2174