All Aetna plans include prescription drug coverage. Some preventive medications [PDF] are not subject to the plan’s annual deductible, and some HCR essential prescribed medications [PDF] are available at no cost.
You pay the full, negotiated cost for other prescription drugs, which counts toward your annual deductible. Once you meet your deductible, you pay only a copay for covered medications. Prescription drug costs count toward your medical out-of-pocket maximum.
The list of medications covered by the plan is called the formulary. The Aetna formulary (Standard Opt Out Plan) shows whether a certain drug is covered as a generic, brand or nonpreferred brand. Check the Aetna website (SSO) or call the number on your member ID card for the cost of a specific drug.
Copays for a 30-day supply: After you meet your plan’s deductible, you’ll pay $15 for generic drugs, $45 for brand-name drugs on the Aetna Performance Drug List and $65 for other brand-name drugs at a network pharmacy.
For medications you take regularly, you can receive a 90-day supply of maintenance drugs by mail-order service or at a CVS pharmacy for the same reduced price.
Copays for a 90-day supply: After you meet your plan’s deductible, you’ll pay $30 for generic drugs, $90 for brand-name drugs on the Aetna Performance Drug List and $130 for other brand-name drugs.
Use the CVS Specialty Pharmacy to fill your prescriptions for specialty medications. CVS Specialty offers personal support, helpful resources and free, secure home delivery.
Call 800-237-2767 with any questions about your specialty medication.