How The Prescription Drug Plan Works |
Available Plans & Costs |
Covered Drugs |
Pharmacies |
Ways To Save More |
Savings Examples |
Eligibility |
Enrollment |
Exceptions & Appeals
Here is an at-a-glance look at all three levels of Aetna's Medicare Rx Plans in your state. For a more detailed description, see the
Summary of Benefits 
.
| Monthly Plan Premium |
$35.94 |
$48.40 |
$64.78 |
| Annual Deductible |
$250 |
$0 |
$0 |
| Amount you pay, up to $2,250 in total covered prescription drug expenses (after meeting deductible): |
| 30-day supply of covered prescription drugs at a retail pharmacy. |
$5 copay for generic drugs.
$25 copay for brand drugs. |
$7 copay for generic drugs.
$35 copay for brand drugs. |
$2 copay for preferred generic drugs.
$20 copay for preferred brand drugs.
$40 copay for non-preferred drugs. |
| 90-day supply of covered prescription drugs through our preferred mail order** vendor,
Aetna Rx Home Delivery®. |
$10 copay for generic drugs.
$50 copay for brand drugs. |
$14 copay for generic drugs.
$70 copay for brand drugs. |
$4 copay for preferred generic drugs.
$40 copay for preferred brand drugs.
$80 copay for non-preferred drugs. |
| Amount you pay between $2,250 in total covered prescription drug expenses, and until you reach $3,600 in out-of-pocket covered prescription drug costs (the "coverage gap"): |
| 30-day supply of covered prescription drugs at a retail pharmacy. |
100% for all drugs. |
$7 copay for generic drugs.
100% for brand drugs. |
$2 copay for preferred generic drugs.
$40 copay for non-preferred generic.
100% for brand drugs. |
| 90-day supply of covered prescription drugs through our preferred mail order** vendor,
Aetna Rx Home Delivery. |
100% for all drugs. |
$14 copay for generic drugs
100% for brand drugs. |
$4 copay for preferred generic drugs.
$80 copay for non-preferred generic.
100% for brand drugs. |
| Amount you pay for covered drugs after reaching $3,600 in out-of-pocket covered prescription drug costs: |
| |
The greater of:
$2 for generics
$5 for brand
OR
5%. |
The greater of:
$2 for generics
$5 for brand
OR
5%. |
The greater of:
$2 for generics
$5 for brand
OR
5%. |
View the Preferred Drug List to see which prescription drugs are covered by these plans.
|
Contact Us
Questions? Call us at 1-800-529-5586 (TTY/TDD 1-800-628-3323)
Monday - Friday, 8:00 a.m. - 6:00 p.m.
Click here for general Medicare information contacts.
M0001_S5810_7A_70702
Updated 10/2007
