Medication Coverage Policies

This section of our website is dedicated to supporting Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) providers with our medication coverage policies.

Dermatologic Disorders

Sep 9th, 2024 Dermatology - Psoriasis Sep 9th, 2024 Dermatology - Other Skin Disorders

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Endocrine Disorders

Gastrointestinal Disorders

Dec 2nd, 2024 Gastrointestinal Disorders - Nausea Sep 9th, 2024 Gastrointestinal - Acute and Chronic Bowel Disease

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Immunology

Mar 10th, 2025 Immunology - Transplant

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Infectious Disease

Dec 2nd, 2024 Infectious Disease - Viral Infections Dec 2nd, 2024 Infectious Disease - Fungal Infections Dec 2nd, 2024 Infectious Disease - Bacterial Infections Jun 14th, 2024 Infectious Disease - Immunizations

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Miscellaneous

Jun 11th, 2025 Miscellaneous - Non-Covered Benefits

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Neurological Disorders

Jun 11th, 2025 Neurologic Disorders - Multiple Sclerosis Dec 2nd, 2024 Neurologic - Migraines

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Oncology

Mar 10th, 2025 Oncology - Cancer

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Ophthalmic Disorders

Jun 14th, 2024 Ophthalmic Disorders - Intravitreal Medications

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Renal Disease/Genitourinary Disorders

Mar 10th, 2025 Renal - Anemia

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Respiratory Disorders

Jun 11th, 2025 Respiratory Disorders - Pulmonary Hypertension Dec 2nd, 2024 Respiratory - Asthma and COPD

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Rheumatologic/Immunologic Disorders

Jun 11th, 2025 Rheumatology - Gout Sep 9th, 2024 Rheumatology - Rheumatoid Arthritis Sep 9th, 2024 Rheumatology - Psoriatic Arthritis Sep 9th, 2024 Rheumatology - Axial Spondyloarthritis

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