Pharmacy Services

formularydownload1CenCal Health Pharmacy Services provides a comprehensive pharmacy benefit that includes formulary management, a robust pharmacy network, and quality customer service. Our pharmacy network spans both Santa Barbara and San Luis Obispo Counties providing our members with convenient pharmacy locations.

Pharmacy Benefit Manager

CenCal Health has contracted with MedImpact as its Pharmacy Benefit Manager (PBM) to assist in the administration of our pharmacy benefit.


epocrates2MedImpact provides: 

  • Claims processing
  • Pharmacy network management
  • Prior authorizations
  • Customer service
  • Drug utilization management services

formsdownloadCenCal Health Pharmacy Team shall oversee MedImpact’s administrative and daily operational role. To contact MedImpact, call: (800) 788-2949.

Our Promise: Our Pharmacy Team is committed to providing consistent, compassionate, local support.

pharmacy news

Formulary Update: Preferred DPP-4 Inhibitors

Effective October 1, 2016, alogliptin products such as generic Nesina, Kazano and Oseni will be the preferred DPP-4 inhibitors on the CenCal Health Formulary. All other DPP-4 inhibitors will be removed from the CenCal Health formulary and a Medication Request Form (MRF) will be required. Januvia, Onglyza, Tradjenta, Janumet, Janumet XR, Jentadueto and Kombiglyze XR will no longer be formulary agents. 

In efforts to minimize any disruption to CenCal Health providers and members during this change, beginning August 1, 2016 providers who have members taking any of the DPP-4 inhibitors will receive a Prescription Change Form via a fax requesting providers to authorize a new prescription to CenCal Health's preferred alogliptin DPP-4 inhibitors. The form will serve as a valid order to begin dispensing the new medication with the next routine prescription fill. 

If the Prescription Change Form is not completed and faxed to MedImpact by October 1, 2016, a MRF will need to be submitted for medical necessity for all non-formulary DPP-4 inhibitors. 

For more information, please contact CenCal Health's Pharmacy Department at (805) 562-1080.

Prepare for 2016-2017 Flu Season

The Flu Season is now upon us. The Pharmacy Flu Program can help your patients stay healthy this flu season. As part of the pharmacy benefits provided by CenCal Health and MedImpact, our members are eligible to receive the flu vaccine directly from a participating pharmacy in our network. CenCal Health members may choose from a variety of participating pharmacy locations including drug stores, supermarkets, retailers and independent pharmacies. Members may contact their local pharmacy for vaccination hours and appointment requirements. If providers chose to administer the flu vaccine in their office, they can bill CenCal Health. 

If you have questions regarding the Pharmacy Flu Program, please contact the CenCal Health Pharmacy Services Department at (800) 421-2560 ext. 1080.

Synagis® Pharmacy Update: RSV Season

CenCal Health would like to assist our members and providers in preparation for the upcoming RSV season. In conjunction with the Department of Health Care Services' Childrens' Medical Services Network, the Synagis® prophylaxis season will begin November 1, 2016, and run through March 31, 2017. Medical Request Forms (MRFs) will be accepted beginning October 1st for initial administration beginning November 1st to ensure that the infant's/child's weight is current. 

Synagis® is required to be ordered through our Specialty Pharmacy vendor, Diplomat Specialty Pharmacy. Order forms for Synagis can be found at : Synagis Form or by contacting Diplomat Specialty Pharmacy directly at (877) 319-6337. Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions or need any assistance. 


Formulary Updates

Formulary Update: Preferred Hepatitis C Regimens

Effective October 1, 2016, CenCal Health will prefer Zepatier™ as the treatment of choice for Hepatitis C Genotype 1 infections and Epclusa® as the treatment of choice for Hepatitis C Genotype 2-6 infections. Sovaldi® and Harvoni® will be removed from the formulary. CenCal Health Prior Authorization requirements, mirroring clincal policy from DHCS, have not changed and will remain in effect for the new preferred regiments. The preferred agent change will be for new starts beginning October 1, 2016 and will not affect any member currently on a non-preferred regiment. 

Formulary Updates July-October 2016

CenCal Health has made several changes to our Formulary based on clinical review, provider interest, cost and utilization analysis. 

All of the changes represent development and growth of our current Formulary thus giving more choices to the prescribing physician. The changes are represented in summary on the chart below.

Class Formulary Status Restriction/Limits  Implementation Date 
Formulary Additions 
Tresiba® Diabetes
Qbrelis™ Cardiovascular Disease-Hypertension  Formulary: Age Restriction Restriction: 12 years of age or less 9/1/2016
 Formulary Changes

Infectious Disease-Viral Formulary: PA Required Preferred Hepatitis C for Genotype 1 10/1/2016
Epclusa® Infectious Disease-Viral Formulary: PA Required Preferred Hepatitis C for Genotypes 2-6 10/1/2016
Harvoni® Infectious Disease-Viral Non-Formulary
Sovaldi® Infectious Disease-Viral Non-Formulary   10/1/2016
Technivie® Infectious Disease-Viral Non-Formulary   10/1/2016
Viekira™ Infectious Disease-Viral Non-Formulary   10/1/2016
Olysio® Infectious Disease-Viral Non-Formulary   10/1/2016
Januvia® Diabetes Non-Fomulary Preferred Nesina, Kazano, or Oseni 10/1/2016
Onglyza® Diabetes Non-Formulary Preferred Nesina, Kazano, or Oseni 10/1/2016
Tradjenta® Diabetes Non-Formulary Preferred Nesina, Kazano, or Oseni 10/1/2016

Janumet XR®
Diabetes Non-Formulary Preferred Nesina, Kazano, or Oseni 10/1/2016
Jentadueto® Diabetes Non-Formulary Preferred Nesina, Kazano, or Oseni 10/1/2016
Kombiglyze XR® Diabetes Non-Formulary Preferred Nesina, Kazano, or Oseni 10/1/2016

specialty pharmacy

Specialty medications are processed uniquely, require special handling, and entail personalized medication management. CenCal Health has contracted exclusively with Diplomat and Accredo Specialty Pharmacy to provide specialty medications for our members. Learn more about specialty medications and review our Specialty Drug List.


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