Pharmacy: Specialty service and program FAQs

What is a Specialty Pharmacy?
A specialty pharmacy fills prescriptions for specialty drugs. These types of drugs may be injected, infused or taken by mouth. Usually, you cannot get these drugs at a local retail pharmacy. And they are not at Aetna’s mail-service pharmacy, Aetna Rx Home Delivery®. They often need special storage and handling. They need to be delivered quickly. And a nurse or pharmacist should check in with you often during your treatment. Aetna Specialty Pharmacy® offers all this and more.

Am I required to use Aetna Specialty Pharmacy?
Your benefits plan may let you use a different specialty pharmacy. But your medication might not be covered or you might have higher out-of-pocket costs.

Why should I use Aetna Specialty Pharmacy over my previous provider?
Aetna Specialty Pharmacy makes sure you understand how to use your medicine and that you always have the right dose. They also work closely with your doctor and other caregivers. Because Aetna Specialty Pharmacy is integrated with Aetna, the pharmacy can access your medical and pharmacy claims data and review your medical history, as needed. This helps monitor your specialty medication needs. The pharmacy can send your medicine anywhere you want. Well-trained nurses and pharmacists are also available to answer your questions 24 hours a day, 7 days a week.

What do I pay for these medicines?
Your benefits plan may require certain out-of-pocket costs for each supply of medicine you receive.

Are there any financial payment plans?
Yes. You may qualify for financial help. Aetna Specialty Pharmacy can tell you if help is available from a manufacturer or through foundations related to your condition. Based on your need, the pharmacy may be able to set up a payment plan for you.

What is the standard day’s supply that I can expect to receive and why?
It is Aetna Specialty Pharmacy’s standard to fill orders for no more than a 30-day supply. A smaller supply lets them check your progress more often. If your drug or dose changes between refills, a smaller supply can help prevent waste and save the policyholder money. Aetna Specialty Pharmacy can only dispense what your benefits plan allows. Any out-of-pocket costs will also depend on your benefits plan.

How easy is it to order a refill?
A week before your next refill, Aetna Specialty Pharmacy will call you to schedule your delivery. During this call, they will coordinate your home health care, if needed. They will also ask:

  • How you are doing with your therapy
  • If you still take the same medicine
  • If you still take the same dose
  • If you are having any side effects
  • If you need more supplies
  • Where you would like your next refill sent

How long does it take to get my order?
You get free, secure delivery within 48 hours after Aetna Specialty Pharmacy confirms your order, or later if you request. There are a few reasons why the ship date could vary. Your medicine may require something called precertification. This means your order must be checked to be sure it meets criteria to be covered. If your order is missing any information, Aetna Specialty Pharmacy may need to call your doctor to confirm it.

Where will you send my medicine and supplies?
We deliver your order, free of charge, to your home, doctor’s office or to any other location you choose. We include all the supplies you need.

How do you make sure I get my order on time?
Aetna Specialty Pharmacy tracks your order throughout the delivery process. They make sure you have the medicine and supplies you need in time for your next dose.

How will my medicine stay safe during delivery?
Refrigerated items are packed in a plastic bag to avoid condensation. The bag is labeled as “refrigerated” and packed inside either a Styrofoam cooler or an insulated pouch. Special ice packs are included to help your medicine stay cool throughout delivery. Each box is secured shut with tamper proof tape.

What if I have questions about my prescription?
Aetna Specialty Pharmacy’s normal business hours are Monday through Friday from 8 a.m. to 7 p.m. ET. The pharmacy’s health care team can answer your questions. Call anytime — day or night — to speak to a nurse or pharmacist. Call toll-free at 1-866-782-ASRX (1-866-782-2779) or TDD: 1-877-833-ASRX (1-877-833-2779).

How important is it to take all of my medicine?
It is important that you follow your doctor’s instructions. Aetna Specialty Pharmacy understands that some drugs may cause side effects or may be hard to take. The pharmacy can help you cope with these issues. You may also find it helpful to talk to your doctor about how to manage side effects.

Where can I learn more about services available from Aetna Specialty Pharmacy?
For more information, please call toll-free at 1-866-782-ASRX (1-866-782-2779) or TDD: 1-877-833-ASRX (1-877-833-2779). 

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