Using the Aetna Medicare formulary
At a glance
- $0 premium plans
- Plans with prescription drug coverage and vision, hearing and dental benefits
- Over 3.3 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. They're available 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 100-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 includes prescription drug coverage (MAPD).
Plans with low copay amounts for Tier 1 and Tier 2 drugs at preferred retail pharmacies and through mail-order delivery.
Medicare Advantage plans provide Original Medicare (Part A and Part B) benefits combined into a single plan.
Aetna Medicare Advantage plans include additional benefits, such as dental, vision and hearing benefits.
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.
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