Participants are eligible for prescription medications on their Medical Home’s Drug Formulary when prescribed by their Healthy San Francisco Medical Home Network provider. Prescription medications can be from a primary care provider or a specialist in the Medical Home network.
Any medications not approved on the Medical Home Network Drug Formulary will not be covered by Healthy San Francisco. Each Medical Home has a designated pharmacy for picking up prescription medicines. Each provider organization or Medical Home Network may also have a different formulary.
For a complete list of Pharmacies, please refer to the Medical Home’s “Prescription” section of the Healthy San Francisco Medical Home Directory.
Participants Receiving Health Services through Community and Behavioral
The pharmacy will consult the SFCBHS Pharmacy Benefits Management company (PBM) to confirm the patient is eligible for services and that the prescribing provider is a SFCBHS provider. Only SFCBHS providers can access specialty psychiatric medications on the SFCBHS formulary.
Participants Receiving Behavioral Care at the Medical Home
Healthy San Francisco Participants receiving behavioral health care at their primary care home are authorized to receive only those medications listed on their Medical Home’s Drug Formulary.