Notes: Aetna covers injectable medications when an appropriate oral alternative drug does not exist. This coverage includes those medications intended to be self-administered. The medication must be medically necessary and appropriate to the member's needs or condition.

Experimental or investigational drugs or drugs that have not been proven safe and effective for a specific disease or approved for a mode of treatment by the FDA and/or the NIH are not covered. This provision does not exclude coverage of established “off label” uses of otherwise FDA-approved prescribed medications.

Drugs related to the treatment of non-covered services are not covered. Infertility injectables are covered only when required by regulation or covered by a specific benefit design. Steroids are not covered for the enhancement of performance, as this is not considered treatment of disease.

Note: Some state-to-state and plan type variations exist.

Certain classes of injectable medications are excluded from coverage under some benefit plans. Please check benefit plan descriptions for details:

1. Anabolic steroids when used for performance enhancement (also see CPB 528 - Androgens and Anabolic Steroids)
2. Infertility injectables* (also see CPB 327 - Infertility)
3. Immunizations for travel (also see CPB 473 - Vaccines for Travel)
4. Contraceptive injectables.** (also see CPB 510 - Progestins)

* Exception: Infertility injectables are covered only when required by regulation or covered by a specific benefit design.

**Contraceptive injectables are covered under plans with the contraceptives rider or under plans with a contraceptives benefit.