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Medicare AdvantageCoverageMedium impact

26-264m Medicare Tier 6: Select Care Drugs

Health Net·CA·Provider News
Effective date
Mar 2, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

HealthNet California is implementing a new Medicare Tier 6 'Select Care Drugs' formulary tier for Medicare Advantage Part D plans in 2026. This creates a new medication tier that will likely affect prescription coverage and patient cost-sharing for certain drugs.

Action Required

Action needed
Before March 2, 2026: Billing team should download and review the Select Care Drugs flyer PDF from HealthNet's provider library to understand which medications are affected by the new Tier 6 formulary. Update medication management workflows and inform providers about potential changes to patient drug coverage and cost-sharing for affected medications.