Using the Aetna Medicare formulary

At a glance

  • $0 premium plans available 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.

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