For some preventive medications [PDF], you pay only your copay or coinsurance, with no deductible. And some essential medications [PDF] are available at no cost to you.
For all other drugs, you pay the full, negotiated cost, which counts toward your annual deductible and your out-of-pocket maximum.
For the cost of a specific drug, log in to the Aetna website (or SSO), or call Aetna at 800-884-9565.
Drug coverage levels after deductible
For most drugs, once you’ve met your deductible, you pay only a copay, which depends on the type of drug, as listed on the Aetna Standard Opt Out Plan drug coverage page. Drugs are categorized as generic, preferred brand, or nonpreferred brand.
| Generic | Preferred brand | Nonpreferred brand | |
|---|---|---|---|
| 30-day supply, in-network retail (after deductible) | $15 | $45 | $65 |
| 90-day supply, CVS retail or mail order (after deductible) | $30 | $90 | $130 |
Specialty medications
For drugs designated on the drug coverage page as specialty drugs, use the CVS Specialty Pharmacy to fill your prescription. Call 800-237-2767 with any questions about your specialty medication.