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Using the Aetna® Medicare formulary
At a glance
- Low or $0 monthly premium plans
- Plans may include prescription drug coverage and vision, hearing or dental benefits
- Over 4 million people are enrolled in an Aetna Medicare Advantage plan1
A Medicare formulary is a list of drugs that are covered by a Medicare plan. A formulary includes details about:
- How each drug is covered
- Any limits and requirements a plan may have for the drug
You can get Aetna® Medicare prescription drug coverage when you enroll in an Aetna Medicare Advantage plan that offers prescription drug coverage (MAPD).
What drugs are covered by Aetna Medicare plans?
An Aetna formulary typically groups drugs by the types of medical conditions they are used to treat. It also lists them in alphabetical order.
To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling 1-877-890-1409 (TTY: 711) 24 hours a day, 7 days a week.*
A licensed insurance agent can use Aetna Medicare plan formularies to help you find Aetna Medicare prescription drug coverage that fits your needs.
What are the drug tier copay levels in a formulary?
A Medicare formulary organizes prescription drugs into tiers. Your copay for each drug may differ based on the tier in which the drug fits.
The amount you pay can vary from one Aetna Medicare plan to another. So be sure to check the plan’s Evidence of Coverage. There, you’ll find the copay or coinsurance amounts you can expect for the plan year.
The formulary tiers are as follows:
- Tier 1: Preferred Generic
- Tier 2: Generic
- Tier 3: Preferred Brand
- Tier 4: Non-Preferred Drug
- Tier 5: Specialty
Generally speaking, lower-cost drugs appear on lower tiers.
Does Aetna offer mail order prescription drug coverage?
Some prescription drugs on an Aetna Medicare plan formulary may be eligible for mail-order delivery through CVS Caremark® Mail Service Pharmacy.
You can typically get up to a 3-month supply for most long-term drugs through this mail-order delivery service. Prescriptions usually arrive within 7 to 10 days.
Some medications aren’t available through mail-order delivery. You can check the plan’s formulary to see which drugs are available.
How can I get Aetna Medicare prescription drug coverage?
You can receive Aetna Medicare prescription drug coverage by enrolling in an Aetna Medicare Advantage plan that includes prescription drug coverage (MAPD).
Plans are available with low copay amounts for Tier 1 and Tier 2 drugs.
Aetna Medicare Advantage plans provide Original Medicare (Part A and Part B) benefits combined into a single plan. They also include additional benefits, such as coverage for dental, vision and hearing.
Aetna Medicare Advantage plans may also include an over-the-counter (OTC) benefit. This benefit covers certain approved items such as vitamins and cold medicine at no additional cost to you.
To learn more about Aetna Medicare plan options or to enroll in an Aetna Medicare plan that includes prescription drug coverage, speak with a licensed insurance agent. You can reach one by calling 1-877-890-1409 (TTY: 711) 24 hours a day, 7 days a week.*
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