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Santa Clara Family Health Plan (SCFHP) Medi-Cal Drug Formulary — List of Covered Drugs



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This Formulary is subject to change. 

Some prescription drugs are required to be billed directly to Medi-Cal Fee-for-Service (FFS). SCFHP is not allowed to cover these drugs for Medi-Cal members. A full list of drugs that are carved out to Medi-Cal FFS is available on the SCFHP Medi-Cal Formulary at www.scfhp.com/medi-cal/forms-documents. 

SCFHP covers the over-the-counter (OTC) drugs listed on the Formulary when they are written as prescriptions by your provider.  

SCFHP is here to help. If you need more information about drug coverage, copayments, the process of submitting prior authorizations or exception requests, or if you would like a printed Formulary for free in another language, call SCFHP Customer Service at 1-800-260-2055 (TTY 711), Monday through Friday, 8:30 a.m. to 5:00 p.m, except holidays. The call is toll free. 
Formulary Effective Date: 09/01/2021
Updated:
09/2021

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