News

Health Net arranged for Shingrix to be administered through contracted pharmacies—while still allowing members to receive it at their doctor’s office if available. Members can get the vaccine at a $0 copay.

Shingrix is an immunization covered under the medical benefit; however, many PCPs do not stock the vaccine, resulting in members being redirected to pharmacies where coverage was previously unavailable.

Availability by line of business

Marketplace (CA IFP): Members can obtain the Shingrix vaccine through a contracted pharmacy at a $0 copay (preventive benefit). This has been effective since 1/1/2026.

Employer Group (Large Group & SBG): Members will be able to access the vaccine through a contracted pharmacy after February 15, 2026 at $0 copay.

Members may also continue to receive the vaccine at their provider’s office if the PPG chooses to continue offering vaccination services.

What You Need To Know – No Action Required

Shingrix will be covered under the pharmacy benefit as a preventive medication at $0 copay. No contract modifications are required. This update resolves the current gap where members were redirected to pharmacies but found the vaccine was not covered.

Note

The Shingrix vaccine is available to members 50 years of age and older. Members may obtain an immunization from their physician or at a participating pharmacy, at no charge.

For More Information or Help Quoting Health Net, Please Contact Your Dickerson Sales Representative.