Using the Aetna Medicare formulary

At a glance:

  • $0 premiums in some areas
  • Many plans offer prescription drug coverage and routine vision and dental benefits
  • About 1.75 million people are enrolled in an Aetna Medicare Advantage Plan1

A Medicare formulary is a list of medications that are covered by a Medicare plan. A formulary includes details about:

  • How each drug is covered
  • Any limits and requirements your 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 Medicare formulary typically lists drugs grouped 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 TTY Users: 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 copay amount you pay will vary from one Aetna Medicare plan to another. So be sure to check your plan’s Summary of Benefits or Evidence of Coverage. In them you’ll find the copay or coinsurance amounts you can expect for the plan year.

The formulary copay 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 drugs on an Aetna Medicare plan formulary may be eligible for home delivery through CVS Caremark® Mail Service Pharmacy.

You can typically get up to a 90-day supply for most medications through this home delivery service. Prescriptions usually arrive within 7 to 10 days.

Some medications aren’t available through home delivery. You can check your 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 include prescription drug coverage (MAPD).

Each plan offers low copay amounts at preferred retail pharmacies and through home delivery.

Medicare Advantage plans provide Original Medicare (Part A and Part B) benefits combined into a single plan.

Many Aetna Medicare Advantage plans include additional benefits, such as prescription drug coverage with low copay amounts at preferred retail pharmacies and through home delivery. Many plans also include routine dental, vision and hearing benefits.

Many Medicare Advantage plans from Aetna may also include an over-the-counter (OTC) benefit. This benefit covers certain items such as vitamins and cold medicine at no extra cost to you.

To learn more about your 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 TTY Users: 711 24 hours a day, 7 days a week.

More Aetna articles

Copyright 2019 TZ Insurance Solutions LLC. All rights reserved.

1 Aetna. Aetna Reports Third-Quarter 2018 Results. (Oct. 30, 2018). Retrieved from

According to internal data from TZ Insurance Solutions in 2018.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

This information is not a complete description of benefits. Call TTY Users: 711 for more information.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members (those who have both Medicare and Medicaid, and meet the state’s requirements for full Medicaid benefits). 

For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10 days. You can call us at the number on your member ID card if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. Other Pharmacies are available in our network.  

Aetna Medicare’s pharmacy network includes limited lower cost, preferred pharmacies in applicable areas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at

Medicare beneficiaries may also enroll in a Medicare Advantage plan through the CMS Medicare Online Enrollment Center located at           

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult

Medicare has neither reviewed nor endorsed this information. is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult

Not all plans or products are available in all markets. Additional plans may be available in your service area.

We comply with applicable Federal civil rights laws and do not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability.  We provide free aids/services to people with disabilities and to people who need language assistance. If you need a qualified interpreter, written information in other formats, translation or other services, contact the phone number on your member identification card. If you believe we have failed to provide these services or otherwise discriminated based on a protected class noted above, you can file a grievance in writing with our Grievance Department (write to the address listed in your Evidence of Coverage) or by phone by calling the phone number on your member identification card (TTY: 711). You can also file a grievance by contacting our Civil Rights Coordinator by phone at 1-855-348-1369, by email at You may file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights Complaint Portal, available at, or at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, or at 1-800-368-1019, 800-537-7697 (TDD).

TTY: 711

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अगर आप अंग्रेजी के अलावा कोई अन्य भाषा बोलते हैं, तो मुफ्त भाषा सहायता सेवाएं उपलब्ध हैं। हमारी वेबसाइट परजाएं या इस दस्तावेज़ में दिए गए फोन नंबर पर कॉल करें। (Hindi)

Nel caso Lei parlasse una lingua diversa dall'inglese, sono disponibili servizi di assistenza linguistica gratuiti. Visiti il nostro sito web oppure chiami il numero di telefono elencato in questo documento. (Italian)

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Jeżeli nie posługują się Państwo językiem angielskim, dostępne są bezpłatne usługi wsparcia językowego. Proszę odwiedzić naszą witrynę lub zadzwonić pod numer podany w niniejszym dokumencie. (Polish)


Nëse nuk flisni gjuhën angleze, shërbime ndihmëse gjuhësore pa pagesë janë në dispozicionin tuaj. Vizitoni faqen tonë në internet ose merrni në telefon numrin e telefonit në këtë dokument. (Albanian)

ከእንግሊዝኛ ሌላ ቋንቋ የሚናገሩ ከሆነ ነጻ የቋንቋ ድጋፍ አገልግሎቶችን ማግኘት ይቻላል። የእኛን ድረ-ገጽ ይጎብኙ ወይም በዚህ ሰነድ ላይ የተዘረዘረውን ስልክ ቁጥር በመጠቀም ይደውሉ። (Amharic)

Եթե խոսում եք անգլերենից բացի մեկ այլ լեզվով, ապա Ձեզ համար հասանելի են լեզվական աջակցման անվճար ծառայություններ։ Այցելեք մեր վեբ կայքը կամ զանգահարեք այս փաստաթղթում նշված հեռախոսահամարով։ (Armenian)

যদি আপনি ইংরেজী ব্যতীত অন্য কোনো ভাষায় কথা বলেনতাহলে বিনামূল্যের দোভাষীর পরিষেবা উপলব্ধ আছে।আমাদের ওয়েবসাইট দেখুন এবং এই নথিতে তালিকাভুক্ত ফোন নম্বরে ফোন করুন। (Bengali)

បើលោកអ្នកនិយាយភាសាផ្សេងក្រៅពីភាសាអង់គ្លេស សេវាកម្មជំនួយ​ផ្នែកភាសាមានផ្ដល់ជូន​ដោយឥតគិតថ្លៃ។ សូមចូលមើលគេហទំព័ររបស់យើងខ្ញុំ ឬហៅទៅកាន់លេខទូរស័ព្ទដែលមានរាយនៅក្នុងឯកសារនេះ។ (Khmer)

Ako govorite neki jezik koji nije engleski, dostupne su besplatne jezičke usluge. Posetite našu internet stranicu ili nazovite broj telefona navedenog u ovom dokumentu. (Serbo-Croatian)

Na ye jam thuɔŋdɛ̈t tënë thoŋ ë Dïŋlïth, ke kuɔɔny luilooi ë thok ë path aa tɔ̈ thïn. Nem ɣöt tɛ̈n internet tɛ̈dë ke yï cɔl akuën cɔ̈tmec cï gat thin në athör du yic. (Dinka)

Als u een andere taal spreekt dan Engels, is er gratis taalondersteuning beschikbaar. Bezoek onze website of bel naar het telefoonnummer in dit document. (Dutch)

Εάν ομιλείτε άλλη γλώσσα εκτός της Αγγλικής, υπάρχουν δωρεάν υπηρεσίες στη γλώσσα σας. Επισκεφθείτε την ιστοσελίδα μας ή καλέστε τον αριθμό τηλεφώνου που αναγράφεται στο παρόν έγγραφο. (Greek)

જો તમે અંગ્રેજી સિવાયની ભાષા બોલતા હો તો મફત ભાષાકીય સહાયતા સેવાઓ ઉપલબ્ધ છે. અમારી વેબસાઇટની મુલાકાત લો અથવા દસ્તાવેજમાં સૂચીબદ્ધ કરવામાં આવેલ ફોન નંબર પર કૉલ કરો. (Gujarati)

Yog hais tias koj hais ib hom lus uas tsis yog lus Askiv, muaj cov kev pab cuam txhais lus dawb pub rau koj. Mus saib peb lub website los yog hu rau tus xov tooj sau teev tseg nyob rau hauv daim ntawv no. (Hmong)

ຖ້າທ່ານເວົ້າພາສານອກເໜືອຈາກອັງກິດ, ການບໍຣິການ ຊ່ວຍເຫຼືອດ້ານພາສາໂດຍບໍ່ເສັຽຄ່າແມ່ນມີໃຫ້ທ່ານ. ໄປທີ່ເວັບໄຊທ໌ຂອງພວກເຮົາ ຫຼື ໂທຕາມເບີໂທລະສັບທີ່ລະບຸໃນເອກະສານນີ້. (Lao)

Bilag1ana bizaad doo bee y1n7[ti’da d00 saad n11n1 [a’ bee y1n7[ti’go, ata’ hane’ t’11 j77k’e bee 1k1 i’doolwo[7g77 h0l=. B44sh nits4kees7 bee na’7d7kid b1 haz’1n7gi 22’1d77l77[ 47 doodago b44sh bee hane’7 bee nihich’8’ hod77lnih d77 naaltsoos bik11’7j8’. (Navajo)

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گر به زبان دیگری بجز انگلیسی گفتگو می کنید، کمک زبانی رایگان فراهم می باشد. به وبسایت ما مراجعه نمایید و یا به شماره تلفن که در سند ذیل لست شده، تماس بگیرید. (Farsi)

ਜੇ ਤੁਸੀਂ ਅੰਗ੍ਰੇਜ਼ੀ ਤੋਂ ਇਲਾਵਾ ਕੋਈ ਹੋਰ ਭਾਸ਼ਾ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਮੁਫ਼ਤ ਭਾਸ਼ਾ ਸਬੰਧੀ ਸਹਾਇਤਾ ਸੇਵਾਵਾਂ ਉਪਲਬਧ ਹਨ। ਸਾਡੀ ਵੈੱਬਸਾਈਟ 'ਤੇਜਾਓ ਜਾਂ ਿੲਸ ਦਸਤਾਵੇਜ਼ ਵਿਚ ਦਿੱਤੇ ਨੰਬਰ 'ਤੇ ਕਾਲ ਕਰੋ। (Punjabi)

Dacă vorbiți o altă limbă decât engleza, aveți la dispoziție servicii gratuite de asistență lingvistică. Vizitați site-ul nostru sau sunați la numărul de telefon specificat în acest document. (Romanian)

ܐܸܢ ܐܲܚܬܘܿܢ ܟܹܐ ܗܲܡܙܡܝܼܬܘܿܢ ܠܸܫܵܢܵܐ ܐَܚܪܹܢܵܐ ܠܸܠ ܠܸܫܵܢܵܐ ܐܸܢܓܠܝܼܙܵܝܵܐ ، ܐܝܼܬܼ ܦܘܼܠܚܵܢܵܐ ܕܡܗܲܝܪܵܢܵܐ ܬܸܫܡܸܬܵܝܵܐ ܕܠܸܫܵܢܵܐ. ܣܲܚܒܪܘܿܢ ܠܫܘܿܦܵܐ ܐܸܠܟܬܪܘܿܢܵܝܵܐ ، ܝܲܢ ܡܵܨܝܼܬܘܿܢ ܩܵܪܝܼܬܘܿܢ ܥܲܠ ܪܲܩܡܵܐ ܕܝܼܠܗ ܕܪܝܵܐ ܓܵܘ ܐܵܗܵܐ ܟܬܼܝܼܒܼܬܵܐ (Syriac)

หากคุณพูดภาษาอื่นนอกเหนือจากภาษาอังกฤษ สามารถขอรับบริการช่วยเหลือด้านภาษาได้ฟรี เข้าไปที่เว็บไซต์ของเรา หรือโทรติดต่อหมายเลขโทรศัพท์ที่แสดงไว้ในเอกสารนี้ (Thai)

Якщо ви не говорите англійською, до ваших послуг безкоштовна служба мовної підтримки. Відвідайте наш веб-сайт або зателефонуйте за номером телефону, що зазначений у цьому документі. (Ukrainian)

اگر آپ انگریزی کے علاوہ دوسری زبان بولتے ہیں تو، زبان سے متعلق مدد کی مفت خدمات دستیاب ہیں۔ ہماری ویب سائٹ ملاحظہ کریں یا اس دستاویز میں درج فون نمبر پر کال کریں۔ (Urdu)

אויב איר רעדט א שפראך אויסער ענגליש, זענען שפראך הילף סערוויסעס אוועילעבל. באזוכט אונזער וועבזייטל אדער רופט דעם טעלעפאן נומער וואס שטייט אויף דעם דאקומענט. (Yiddish)

Last Updated 05/21/2019


Accepted 05/2019