IEHP Covered California

IEHP Covered California

Plan Overview

IEHP Covered California offers the lowest cost Silver plan in the Inland Empire.  For those who qualify, enhanced or cost share reduction (CSR) Silver plans have $0 deductibles and lower out-of-pocket costs compared to other plan options. IEHP Covered California offers Bronze, Silver, Gold, Platinum, and additional plans depending on your health care needs. The IEHP Covered California network providers are local and focused on quality of care. Prescription drug coverage consists of generic, brand, and specialty drugs. 

Plan Benefits

IEHP Covered California offers free preventative care on all plans. and various plans to choose from depending on your health care needs.  The Summary of Benefits & Coverage (SBC) provides a summary of benefits, cost shares and important coverage details in an easy-to-read format. The Evidence of Coverage provides a description of health services provided through IEHP Covered California.

Who is eligible for IEHP Covered California?

IEHP Covered California is limited to residents of San Bernardino or Riverside counties.

IEHP Covered California Formulary

The IEHP Covered California Formulary is a continually updated list of drug products designed to reflect the most appropriate, high quality and cost-effective drug therapies.

 

IEHP members have prescription drug coverage through MedImpact Healthcare Systems, a pharmacy benefit management (PBM) company to administer its prescription drug benefit. The Pharmacy and Therapeutics (P & T) Committee is a standing committee of MedImpact and is responsible for clinical recommendations for the therapeutic use of drugs on the MedImpact Formulary. The P & T Committee consists of practicing physicians, practicing pharmacists, psychiatrists, pediatricians, and other mental health prescribing practitioner. This panel reviews the medications in all therapeutic categories and makes decisions based on safety, clinical efficacy, and, cost-effectiveness and selects the most appropriate drugs in each class.

 

Formulary development and maintenance is a dynamic process. The P & T Committee is responsible for developing, managing, and updating the Formulary. The P & T Committee also ensures that the IEHP Covered California Formulary remains responsive to the needs of our members and providers.

 

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website.

IEHP Covered California Plan Items:

Exceptions to criteria or requests for coverage of drugs not on the IEHP Covered California Formulary may be submitted by prescribers on CoverMyMeds or the IEHP pharmacy benefits website https://www.medimpact.com/Prior-Authorization-Forms. IEHP delegates prior authorization requests to the Pharmacy Benefit Managers (PBM). Grievance and Appeals and Physician Administered Drugs (PAD) prior authorization requests are reviewed by IEHP.

 

Information on this page is current as of June 17, 2024