Pharmacy Benefit
Prescription drug coverage is included under Aetna's Aetna Select plan benefits. There are two ways to save on prescription drugs: at retail pharmacies or by mail.
Retail Pharmacy
When your doctor prescribes medication for a short-term illness or injury, you can fill your prescription for up to a 30-day supply at a retail pharmacy. If you visit a retail pharmacy that belongs to Aetna's national network (participating pharmacy), you'll pay your share of the cost for your medication when you pick it up. If you visit a non-participating pharmacy, you'll pay the entire cost of your prescription when you pick it up, then file a claim for reimbursement under the terms of your plan.
For a list of participating retail pharmacies, visit Custom DocFind®
Aetna Rx Home Delivery® *
If you or a family member take a maintenance medication regularly, Aetna offers an easy way to obtain them through the mail and are delivered right to your door.
The Aetna Rx Home Delivery Web site provides simple instructions to help you order your mail order refills online or to check the status of an order.
Please note: Initial orders for a supply of covered medication cannot be submitted via the Internet. Members must submit an original prescription, with their member ID number written on the back, along with the New Participant Order Form. You can click on the link below and print a copy of the form.
Aetna Rx Home Delivery must comply with all applicable dispensing laws. Those requirements include, but are not limited to:
- Prescriptions cannot be faxed by the member (they can be faxed by the provider's office).
- In order for Schedule II medications to be dispensed in any quantity greater than a 30-day supply, your physician must write the diagnosis on the prescription. Some examples of Schedule II medications are Ritalin, Oxycontin and MS Contin.
- Pharmacies are prohibited by law to fill a prescription that is more than one year old even if there are refills remaining.
New Participant Order Form
*Aetna Rx Home Delivery is an affiliate of Aetna Inc., a licensed mail order pharmacy.
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1. The lowest copay or coinsurance level is $5 or 10% of the cost (whichever is greater) for up to a 30-day supply of generic drugs included on Aetna's preferred drug list.
2. The middle copay or coinsurance level is $20 or 10% of the cost (whichever is greater) for up to a 30-day supply of brand-name drugs included on Aetna's preferred drug list.
3. The highest copay or coinsurance level is $40 or 10% of the cost (whichever is greater) for up to a 30-day supply of brand-name drugs that are not included on Aetna's preferred drug list.
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The Preferred (Formulary) Drug Guide
Aetna's Preferred Drug Guide provides information regarding medications covered under the Aetna Select Plan The guide, also contains information about prescription drug costs and shows lower-cost alternatives to non-preferred drugs. Typically, generics are the least expensive and non-formulary brand-name drugs the most costly.
The Preferred (Formulary) Drug Guide contains tools that allow you to:
- Print out the preferred list, so you can talk to your doctor about lower cost alternatives to high-cost drugs.
- Search for lower-cost prescription drug alternatives.
- Review Rx coverage policy bulletins for drugs that require precertification or step therapy.
- Find information about Aetna's Preferred Specialty Networks. These networks specialize in dispensing such drugs as self-injectables or compounds.
- Review a list of Frequently Asked Questions.
Click here to view the Aetna Formulary Guide and Disclosures
Aetna Pharmacy Website
The new Aetna Pharmacy Web site will help you maximize your pharmacy benefits by providing you with tools and resources to manage your health and reduce your medication costs.
Site features include:
- Preferred (Formulary) Drug Guide
- Information on how to refill your medications through Aetna Rx Home Delivery
- Answers to frequently asked questions
- Money-saving tips
- Interactive videos
- A health-information encyclopedia
- Information on medications, generic drugs and drug safety
- Get well e-cards, and
- A virtual herb garden
Price-A-DrugSM, available on Aetna Navigator, provides the retail and mail-order prices of prescriptions drugs, shows your copay or coinsurance amounts and tells you whether or not a generic substitute is available.
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